Surgical robot systems comprising robotic telemanipulators and integrated laparoscopy

ABSTRACT

Surgical robot systems for remote manipulation having robotic telemanipulators are provided. The surgical robot systems are well adapted for use by the surgeon, seamlessly integrateable into the operation room, allow for a surgeon to work between the robot and the patient throughout a surgery in a sterile manner, are relatively low cost, and/or permit integrated laparoscopy. The system preferably includes a master console having a plurality of master links interconnected by a plurality of master joints, and a handle coupled to the master console for operating the telemanipulator. The system further includes a slave console operatively coupled to the master console and having a plurality of slave links interconnected by a plurality of slave joints that move responsive to movement at the master console to permit an end-effector to perform surgery.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/269,383, filed Feb. 6, 2019, which claims the benefit of priority ofU.S. Provisional Patent Application Ser. No. 62/788,781, filed Jan. 5,2019, and U.S. Provisional Patent Application Ser. No. 62/627,554, filedFeb. 7, 2018, the entire contents of each of which are incorporatedherein by reference.

FIELD OF USE

This application generally relates to remotely actuated surgical robotsystems having robotic telemanipulators.

BACKGROUND

Numerous environments and applications call for remote actuation withteleoperated surgical devices. These applications include the ability toperform fine manipulation, to manipulate in confined spaces, manipulatein dangerous or contaminated environments, in clean-room or sterileenvironments and in surgical environments, whether open field orminimally invasive. While these applications vary, along with parameterssuch as precise tolerances and the level of skill of the end user, eachdemands many of the same features from a teleoperated system, such asthe ability to carry out dexterous manipulation with high precision.

Surgical applications are discussed in the following disclosure in moredetail as exemplary of applications for a teleoperated device systemwhere known devices exist but significant shortcomings are evident inpreviously-known systems and methods.

Open surgery is still the preferred method for many surgical procedures.It has been used by the medical community for many decades and typicallyrequired making long incisions in the abdomen or other area of the body,through which traditional surgical tools are inserted. Due to suchincisions, this extremely invasive approach results in substantial bloodloss during surgery and, typically, long and painful recuperationperiods in a hospital setting.

Laparoscopy, a minimally invasive technique, was developed to overcomesome of the disadvantages of open surgery. Instead of large through-wallincisions, several small openings are made in the patient through whichlong and thin surgical instruments and endoscopic cameras are inserted.The minimally invasive nature of laparoscopic procedures reduces bloodloss and pain and shortens hospital stays. When performed by experiencedsurgeons, a laparoscopic technique can attain clinical outcomes similarto open surgery. However, despite the above-mentioned advantages,laparoscopy requires a high degree of skill to successfully manipulatethe rigid and long instrumentation used in such procedures. Typically,the entry incision acts as a point of rotation, decreasing the freedomfor positioning and orientating the instruments inside the patient. Themovements of the surgeon's hand about this incision point are invertedand scaled-up relative to the instrument tip (“fulcrum effect”), whichreduces dexterity and sensitivity and magnifies any tremors of thesurgeon's hands. In addition, the long and straight instruments forcethe surgeon to work in an uncomfortable posture for hands, arms andbody, which can be tremendously tiring during a prolonged procedure.Therefore, due to these drawbacks of laparoscopic instrumentation,minimally invasive techniques are mainly limited to use in simplesurgeries, while only a small minority of surgeons is able to use suchinstrumentation and methods in complex procedures.

To overcome the foregoing limitations of previously-known systems,surgical robotic systems were developed to provide an easier-to-useapproach to complex minimally invasive surgeries. By means of acomputerized robotic interface, those systems enable the performance ofremote laparoscopy where the surgeon sits at a console manipulating twomaster manipulators to perform the operation through several smallincisions. Like laparoscopy, the robotic approach is also minimallyinvasive, providing the above-mentioned advantages over open surgerywith respect to reduced pain, blood loss, and recuperation time. Inaddition, it also offers better ergonomy for the surgeon compared toopen and laparoscopic techniques, improved dexterity, precision, andtremor suppression, and the removal of the fulcrum effect. Althoughbeing technically easier, robotic surgery still involves severaldrawbacks. One major disadvantage of previously-known robotic surgicalsystems relates to the extremely high complexity of such systems, whichcontain four to five robotic arms to replace the hands of both thesurgeon and the assistant, integrated endoscopic imaging systems, aswell as the ability to perform remote surgery, leading to huge capitalcosts for acquisition and maintenance, and limiting the affordably forthe majority of surgical departments worldwide. Another drawback ofthese systems is the bulkiness of previously-known surgical robots,which compete for precious space within the operating room environmentand significantly increasing preparation time. Access to the patientthus may be impaired, which raises safety concerns.

For example, the da Vinci® surgical systems (available by IntuitiveSurgical, Inc., Sunnyvale, Calif., USA) is a robotic surgical system forallowing performance of remote laparoscopy by a surgeon. However, the daVinci® surgical systems are very complex robotic systems, with eachsystem costing around $2,000,000 per robot, $150,000 per year forservicing, and $2,000 per surgery for surgical instruments. The daVinci® surgical system also requires a lot of space in the operatingroom, making it hard to move around to a desired location within theoperating room, and difficult to switch between forward and reversesurgical workspaces (also known as multi-quadrant surgery).

Moreover, as the surgeon's operating console is typically positionedaway from the surgical site, the surgeon and the operating console arenot in the sterile zone of the operating room. If the surgeon'soperating console is not sterile, the surgeon is not permitted to attendto the patient if necessary without undergoing additional sterilizationprocedures. During certain surgical operations, a surgeon may need tointervene at a moment's notice, and current bulky robotic systems mayprevent the surgeon from quickly accessing the surgical site on thepatient in a timely, life-saving manner.

WO97/43942 to Madhani, WO98/25666 to Cooper, and U.S. Patent ApplicationPublication No. 2010/0011900 to Burbank each discloses a roboticteleoperated surgical instrument designed to replicate a surgeon's handmovements inside the patient's body. By means of a computerized, roboticinterface, the instrument enables the performance of remote laparoscopy,in which the surgeon, seated at a console and manipulating twojoysticks, performs the operation through several small incisions. Thosesystems do not have autonomy or artificial intelligence, beingessentially a sophisticated tool that is fully controlled by thesurgeon. The control commands are transmitted between the robotic masterand robotic slave by a complex computer-controlled mechatronic system,which is extremely costly to produce and maintain and requiresconsiderable training for the hospital staff.

WO2013/014621 to Beira, the entire contents of which are incorporatedherein by reference, describes a mechanical teleoperated device forremote manipulation which comprises master-slave configuration includinga slave unit driven by a kinematically equivalent master unit, such thateach part of the slave unit mimics the movement of a corresponding partof the master unit. A typical master-slave telemanipulator providesmovement in seven degrees-of-freedom. Specifically, these degrees offreedom include three translational macro movements, e.g.,inward/outward, upward/downward, and left/right degrees-of-freedoms, andfour micro movements including one rotational degree-of-freedom, e.g.,pronosupination, two articulation degrees-of-freedom, e.g., yaw andpitch, and one actuation degree-of-freedom, e.g., open/close. Althoughthe mechanical transmission system described in that publication is welladapted to the device, the low-friction routing of the cables fromhandles through the entire kinematic chain to the instruments is costly,complex, bulky, and requires precise calibration and careful handlingand maintenance.

In addition, previously-known purely mechanical solutions do not offerwrist alignment, low device complexity, low mass and inertia, highsurgical volume, and good haptic feedback. For example, with a purelymechanical teleoperated device, in order to perform a purepronosupination/roll movement of the instrument, the surgeon typicallyhas to perform a combined pronosupination/roll movement of hishand/forearm as well as a translational movement on a curved path withhis wrist. Such movements are complex to execute properly, and if notdone properly, the end-effector pitches and yaws creating undesiredparasitic movements.

Further, the routing of the articulation and actuationdegrees-of-freedom cables through mechanical telemanipulators may limitthe dexterity of the angular range of the various joints of thetelemanipulator link-and-joint structure. This in turn limits theavailable surgical volume of the instruments accessible within thepatient. During rapid movements of the mechanical telemanipulators,inertia of the telemanipulators also may be disturbing and result inover-shoot of the target and fatigue of the surgeon's hand. Part of thismass can be attributed to parts and components required to route theactuation and articulation degrees-of-freedom.

Accordingly, it would be desirable to provide remotely actuated surgicalrobot systems having robotic telemanipulators that are well adapted foruse by the surgeon, seamlessly integrated into the operation room, allowfor a surgeon to work between the robot and the patient in a sterilemanner, are relatively low cost, and/or permit integrated laparoscopy.

It would further be desirable to provide a remotely actuated surgicalrobot having mechanical and/or electromechanical telemanipulators.

SUMMARY

The present invention overcomes the drawbacks of previously-knownsystems by providing remotely actuated surgical robot systems havingrobotic telemanipulators that are preferably well adapted for use by thesurgeon, seamlessly integrateable into the operation room, allow for asurgeon to work between the robot and the patient throughout a surgeryin a sterile manner, are relatively low cost, and/or permit integratedlaparoscopy.

The surgical robot system for remote manipulation includes a masterconsole having a plurality of master links, and a handle coupled to themaster console such that movement applied at the handle moves at leastone of the plurality of master links. The master console may be designedto remain sterile during the surgery. In accordance with one aspect, thehandle may be removeably coupled to the master console such that thehandle is sterile during the surgery and sterilizable while removed foradditional surgeries. For example, the handle may be removeably coupledto the master console via, e.g., a clip attachment or a screwattachment. The removable handle may be purely mechanical withoutelectronics such as circuits, sensors, or electrically coupled buttonsto facilitate sterilization between surgeries while the handle isremoved from the master console. In this manner, the master console maybe sterile (e.g., covered with a sterile drape except at the handles)during the surgery while permitting the surgeon to have the tactilefeedback available from direct contact with the robot's handles.

The surgical robot system further includes a slave console having aplurality of slave links. In accordance with one aspect, the distal endof the slave console may be rotatable about an alpha-axis of anangulation slave link of the plurality slave links such that the distalend of the slave console is positionable in a manner to permit a user tomove from the master console to manually perform a laparoscopicprocedure on a patient undergoing the surgery.

In addition, the system includes an end-effector coupled to the slaveconsole, wherein the end-effector moves responsive to movement appliedat the handle and responsive to movement at the slave console to performthe surgery. For example, the slave console may include a plurality ofactuators, e.g., motors, operatively coupled to the end-effector that,when activated responsive to actuation at the handle, applytranslational macro-movements to the plurality of slave links during amacro-synchronization state, but not in an unsynchronized macro state,and apply micro-movements to the end-effector during amicro-synchronization state, but not in an unsynchronized micro state.Moreover, the surgical robot system may include an instrument having aproximal end and a distal end, the proximal end having an instrument hubdesigned to be coupled to the distal end of the slave console, and thedistal end having the end-effector.

The handle may include a retractable piston that moves responsive toactuation of the handle. Thus, at least one sensor of the master consoleis designed to sense movement of the retractable piston to cause theplurality of actuators to make corresponding micro-movements at theend-effector. In accordance with one aspect of the present invention,the slave console does not respond to movement at the master consoleunless the at least one sensor senses at least a predetermined amount ofthe retractable piston. Further, at least one sensor coupled to thehandle may be designed to sense an actuation pattern of the handle thattransitions the robot from an unsynchronized micro state to themicro-synchronized state. For example, in the unsynchronized microstate, movement at the handle sensed by the plurality of sensors doesnot a cause corresponding micro-movement by the end-effector until therobot is transitioned to the micro-synchronized state because the atleast one sensor senses the actuation pattern of the handle.

The master console may include a mechanical constraint designed toconstrain movement of at least one master link of the plurality ofmaster links, and may further include a clutch that when actuatedprevents translational macro-movement of the plurality of master links.The surgical robot system further may include a display coupled to themaster console that permits a user to visualize the end-effector duringoperation of the telemanipulator. Additionally, the system may include aremovable incision pointer that permits alignment of the distal end ofthe slave console with a trocar positioned within a patient undergoingthe surgery.

Moreover, the base of the slave console may be coupled to a proximalslave link of the plurality of slave links via a proximal slave joint ofa plurality of slave joints such that the plurality of slave links andjoints are moveable about the proximal slave joint to position thedistal end of the slave console at a desired horizontal location priorto performing the surgery while the base of the slave console remainsstationary. In addition, the base of the slave console may include anadjustable vertical column coupled to the proximal slave link of theplurality of slave links. The adjustable vertical column may adjust aheight of the plurality of slave links and joints to position the distalend of the slave console at a desired vertical location prior tooperation of the telemanipulator.

In accordance with one aspect of the present application, slave linksand joints of the pluralities of slave links and joints distal to a betajoint of the plurality of slave joints are designed to move relative tothe beta joint to flip the distal end of the slave console between aforward surgical workspace and a reverse surgical workspace while slavelinks of the plurality of slave links proximal to the beta joint, and abase of the slave console, remain stationary.

The surgical robot system also may include a controller operativelycoupled to the plurality of actuators such that the plurality ofactuators apply movement to the plurality of slave links of the slaveconsole responsive to instructions executed by the controller. Forexample, the controller may execute instructions to cause the pluralityof actuators to move the plurality of slave links of the slave consoleto a home configuration where, in the home configuration, the pluralityof slave links are retracted such that the end-effector is positionablewithin a trocar inserted in a patient undergoing the surgery. Inaddition, the controller may execute instructions to cause the pluralityof actuators to move an angulation slave link of the plurality slavelinks to an angle such that the angulation slave link and the slavelinks of the slave console proximal to the angulation slave link remainstationary during operation of the telemanipulator. Accordingly, at theangle of the angulation slave link, the distal end of the slave consolepermits the end-effector to perform the surgery in a semi-sphericalsurgical workspace tilted at an angle essentially parallel to the angleof the angulation slave link.

In accordance with another aspect of the present invention, the masterconsole has a master controller and the slave console has a slavecontroller, such that the master controller may execute instructionsbased on movement sensed at the handle and transmit signals to the slavecontroller based on the movement. Accordingly, the slave controller mayreceive the signals and execute instructions to move at least one of theplurality of slave links or the end-effector, or both, based on thesignals transmitted from the master controller. For example, the slaveconsole may include a right slave telemanipulator, a right slavecontroller, a left slave telemanipulator, and a left slave controller,and the master console may include a right master telemanipulator, aleft master telemanipulator, and master controller, such that, in aforward surgical workspace configuration, the master controllercommunicates with the right slave controller to cause the right slavetelemanipulator to move responsive to movement at the right mastertelemanipulator and the master controller communicates with the leftslave controller to cause the left slave telemanipulator to moveresponsive to movement at the left master telemanipulator. Additionally,in accordance with some embodiments, in a reverse surgical workspaceconfiguration, the master controller communicates with the left slavecontroller to cause the left slave telemanipulator to move responsive tomovement at the right master telemanipulator and the master controllercommunicates with the right slave controller to cause the right slavetelemanipulator to move responsive to movement at the left mastertelemanipulator.

Accordingly, a distal end of the right slave telemanipulator may berotatable about the alpha-axis of a right angulation slave link of theplurality of right slave links, and a distal end of the left slavetelemanipulator may be rotatable about the alpha-axis of a leftangulation slave link of the plurality of left slave links such that thedistal ends of the right and left slave telemanipulators arepositionable in a manner to permit a user to move from the masterconsole to manually perform a laparoscopic procedure on a patientundergoing the surgery. In addition, the right handle may be removeablycoupled to the right master telemanipulator and the left handle may beremoveably coupled to the left master telemanipulator.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an exemplary remotely actuated surgical robot system havingrobotic telemanipulators constructed in accordance with the principlesof the present invention.

FIG. 2A shows an exemplary master console constructed in accordance withthe principles of the present invention.

FIG. 2B shows an exemplary display constructed in accordance with theprinciples of the present invention.

FIG. 3A shows the master console of FIG. 2A in a seated configuration,and FIGS. 3B and 3C show the master console of FIG. 2A in a standingconfiguration.

FIG. 4 shows an exemplary master console handle constructed inaccordance with the principles of the present invention.

FIG. 5A shows an exemplary handle grip constructed in accordance withthe principles of the present invention. FIGS. 5B and 5C show the handlegrip of FIG. 5A removeably coupling with the master console handle ofFIG. 4A in accordance with the principles of the present invention.

FIGS. 6A-6C show an exemplary handle grip removeably coupling with amaster console handle via a clip attachment in accordance with theprinciples of the present invention.

FIG. 7 shows an exemplary handle grip removeably coupling with a masterconsole handle via a screw attachment in accordance with the principlesof the present invention.

FIGS. 8A-8C show actuation steps of the handle grip of FIG. 5A inaccordance with the principles of the present invention.

FIGS. 9A and 9B are cross-sectional views of the handle grip of FIG. 5Acoupled to the master console handle.

FIGS. 10A-10C show another exemplary master console handle constructedin accordance with the principles of the present invention.

FIGS. 11A and 11B show an exemplary slave console constructed inaccordance with the principles of the present invention.

FIG. 12 shows a left slave console constructed in accordance with theprinciples of the present invention.

FIG. 13 shows an exemplary controller of the remotely actuated surgicalrobot system.

FIGS. 14A-14E show Scara movement of the slave console in accordancewith the principles of the present invention.

FIGS. 15A-15C show vertical adjustment of the slave console inaccordance with the principles of the present invention.

FIG. 16 shows the slave console in a home configuration in accordancewith the principles of the present invention.

FIGS. 17A-17D show movement of an exemplary translational instrumentinterface coupled to the slave console in a forward configuration duringzero-degree angulation of the slave console.

FIGS. 18A-18D illustrates the forward surgical workspace of FIGS.17A-17D.

FIG. 18E is a back view of the forward surgical workspace of the slaveconsole of FIGS. 18A-18D.

FIGS. 19A-19C show the forward surgical workspace of an exemplaryinstrument coupled to the slave console in a forward configurationduring twenty-degree angulation of the slave console.

FIGS. 20A-20C show the forward surgical workspace of an exemplaryinstrument coupled to the slave console in a forward configurationduring forty-degree angulation of the slave console.

FIGS. 21A-21J show flipping of the slave console between a forwardconfiguration and a reverse configuration in accordance with theprinciples of the present invention.

FIGS. 21K and 21L are a schematic of the master console and slaveconsole during the forward configuration and the reverse configuration,respectively, in accordance with the principles of the presentinvention.

FIGS. 22A-22C show an exemplary translational instrument interfacecoupled to the slave console in a reverse configuration during zero,twenty, and forty-degree angulation, respectively, of the slave console.

FIGS. 23A-23C illustrates the reverse surgical workspaces of FIGS.22A-22C.

FIGS. 24A-24D show adjustment of the slave console for integratedlaparoscopy in accordance with the principles of the present invention.

FIG. 25 is a flow chart illustrating use of the remotely actuatedsurgical robot system of FIG. 1 in accordance with the principles of thepresent invention.

FIG. 26 is a flow chart illustrating the surgeon console positioningstep of FIG. 25 in accordance with the principles of the presentinvention.

FIG. 27 is a flow chart illustrating the preparation step of FIG. 25 inaccordance with the principles of the present invention.

FIG. 28 is a flow chart illustrating the ready for instrument step ofFIG. 25 in accordance with the principles of the present invention.

FIG. 29 is a flow chart illustrating the ready for operation step ofFIG. 25 in accordance with the principles of the present invention.

FIG. 30 is a flow chart illustrating the operating step of FIG. 25 inaccordance with the principles of the present invention.

FIGS. 31A and 31B show an exemplary remotely actuated surgical robotsystem having hybrid telemanipulators constructed in accordance with theprinciples of the present invention.

FIGS. 32A and 32B show partially exploded perspective views of thesurgical robot system of FIGS. 31A and 31B.

FIG. 33 shows a top view, partially exploded, of an exemplary mechanicaltransmission system constructed in accordance with the principles of thepresent invention.

FIGS. 34A and 34B show side perspective views of an exemplary masterunit constructed in accordance with the principles of the presentinvention.

FIGS. 34C and 34D show alternative embodiments of a handle suitable foruse with the master unit depicted in FIGS. 34A and 34B.

FIGS. 35A and 35B show side perspective views of an exemplary slave unitconstructed in accordance with the principles of the present invention.

FIGS. 36A and 36B show, respectively, an end sectional and side interiorperspective view of an exemplary slave hub.

FIGS. 36C and 36D are, respectively, a perspective side view of a slaveinstrument and a detailed interior view of an end-effector constructedin accordance with the principles of the present invention.

FIG. 36E is a detailed view of an alternative embodiment of an exemplaryend-effector.

FIG. 37 shows a flow chart illustrating exemplary method steps foridentifying the kinematics of a selected end-effector.

FIG. 38 shows an alternative exemplary embodiment of a remotely actuatedsurgical robot system of the present invention.

FIG. 39 shows interior side perspective view of the master unit of theremotely actuated surgical robot system of FIG. 38.

FIGS. 40A and 40B are forward and rearward perspective views of theslave unit of the remotely actuated surgical robot system of FIG. 38.

FIGS. 41A and 41B are alternative schematic illustrations of a controlsystem suitable for use in the surgical robot system of the presentinvention.

FIGS. 42A and 42B are side perspective views of alternative embodimentsof telemanipulators constructed in accordance with the principles of thepresent invention.

DETAILED DESCRIPTION

A remotely actuated surgical robot system having robotictelemanipulators and integrated laparoscopy, which may be used inminimally invasive surgical procedures or in other applications,constructed in accordance with the principles of the present invention,is described herein. The surgical robot system provides the value ofrobotics for long and difficult surgical tasks such as suturing anddissection, and permits a user, e.g., a surgeon, to efficiently switchto integrated laparoscopy for short and specialized surgical tasks suchas vessel sealing and stapling. The fully articulated instrumentssimplify complex surgical tasks, and replication of hand movementsincrease precision. The user may be seated or standing in a relaxedergonomic working position to improve surgeon focus and performance.

Referring to FIG. 1, exemplary remotely actuated surgical robot system10 having robotic telemanipulators is described. Surgical robot system10 includes master console 20 electrically and operatively coupled toslave console 50 via, e.g., electrical cables. As described in furtherdetail below, surgical robot system 10 includes a macro-synchronizationstate where a plurality of actuators, e.g., preferably motors, coupledto slave console 50 applies translational macro-movements to anend-effector of slave console 50 responsive to movement applied atmaster console 20 via a processor-driven control system, and amicro-synchronization state where a plurality of actuators, e.g.,preferably motors, coupled to slave console 50 applies micro-movementsto an end-effector of slave console 50 responsive to movement applied ata handle of master console 20 via the processor-driven control system.

The control system may include master controller 2 operatively coupledto right master telemanipulator 22 a and left master telemanipulator 22b of master console 20, and slave controllers 4 a and 4 b operativelycoupled to right slave telemanipulator 51 a and left slavetelemanipulator 51 b of slave console 50, respectively. For example,master controller 2 may include non-transitory computer readable media,e.g., memory, having instructions stored thereon that, when executed byone or more processors of master controller 2, allow operation of masterconsole 20. Similarly, slave controllers 4 a and 4 b may each includenon-transitory computer readable media, e.g., memory, havinginstructions stored thereon that, when executed by one or moreprocessors of respective slave controllers 4 a, 4 b, allow operation ofslave console 50. Master controller 2 is operatively coupled to slavecontroller 4 a and slave controller 4 b via communication links such ascables (as illustrated) or via wireless communication components.

Master controller 2 may be operatively coupled to one or more sensors ofmaster console 20, and slave controllers 4 a, 4 b may be operativelycoupled to one or more actuators of slave console 50 such that mastercontroller 2 may receive signals indicative of movement applied atmaster console 20 by the one or more sensors of master console 20, andexecute instructions stored thereon to perform coordinate transformsnecessary to activate the one or more actuators of slave console 50,send the processed signals to respective slave controllers 4 a, 4 b thatexecute instructions stored thereon to move slave console 50 in a mannercorresponding to movement of master console 20 based on the processedsignals. For example, the one or more actuators may include one or moremotors. Alternatively, master controller 2 may receive the signals fromthe one or more sensors of master console 20, process the signals, andtransmit the processed signals to respective slave controllers 4 a, 4 bwhich execute instructions stored thereon to perform the coordinatetransforms based on the processed signals, and execute instructions toactivate the one or more actuators of slave console 50 to move slaveconsole 50 in a manner corresponding to movement of master console 20based on the transformed, processed signals. Preferably, the slave linksand joints of slave console 50 move in a manner such that theend-effector/instrument tip replicates the movement applied at thehandle of master console 20, without deviating, during operation ofsurgical robot system 10, from a remote center-of-motion, as describedin further detail below. Thus, translation degrees-of-freedom, e.g.,left/right, upward/downward, inward/outward, the articulationdegrees-of-freedom, e.g., pitch and yaw, the actuationdegrees-of-freedom, e.g., open/close, and the rotationdegree-of-freedom, e.g., pronosupination, are electromechanicallyreplicated via sensors, actuators, and a control system as described infurther detail below.

Master console 20 may be positioned within the operating room where auser, e.g., surgeon, may be situated, and in close proximity to slaveconsole 50 where a patient undergoing surgery may be situated, e.g., thesterile zone, so that the user may move quickly between master console20 and slave console 50 to manually perform laparoscopy during thesurgery if necessary. Accordingly, slave console 50 is designed toefficiently retract to a configuration to permit the surgeon to accessthe surgical site on the patient as described in further detail below.Master console 20 may be covered with a sterile drape, and may includeremovable handles that may be removed and sterilizable between surgeriessuch that the handles are sterile during the surgery and there are nophysical barriers between the handles and the surgeon's hands, therebyimproving control and performance by the surgeon. The removable handlemay be purely mechanical without electronics such as circuits, sensors,or electrically coupled buttons so that the removable handle is easilysterilizable between surgeries. In this manner, the master console maybe sterile during the surgery while permitting the surgeon to have thetactile feedback available from direct contact with the robot's handles.

As illustrated in FIG. 1, master console 20 includes right mastertelemanipulator 22 a and left master telemanipulator 22 b. Right mastertelemanipulator 22 a and left master telemanipulator 22 b may bepositioned on a single master console such that right mastertelemanipulator 22 a may be manipulated by the surgeon's right hand andleft master telemanipulator 22 b may be manipulated by the surgeon'sleft hand when the surgeon is situated at master console 20.Accordingly, master console 20 may include wheels for mobility withinthe operating room, and wheel locks that may be actuated to lock thetelemanipulators in position, e.g., during storage or during use by thesurgeon during the surgery. In addition, right master telemanipulator 22a and left master telemanipulator 22 b may be operated simultaneouslyand independently from the other, e.g., by the surgeon's right and lefthands. Preferably, surgical robot system 10 is optimized for use insurgical procedures.

As further illustrated in FIG. 1, slave console 50 includes right slavetelemanipulator 51 a operatively coupled to right master telemanipulator22 a, and left slave telemanipulator 51 b operatively coupled to leftmaster telemanipulator 22 b. Right and left slave telemanipulators 51 aand 51 b may be positioned on separate consoles such that right slavetelemanipulator 51 a may be positioned on the right side of the patientundergoing surgery and left slave telemanipulator may be positioned onthe left side of the patient. Accordingly, right and left slavetelemanipulators 51 a and 51 b each may include wheels for mobilitywithin the operating room, and floor locks that may be actuated to lockthe telemanipulators in position, e.g., during storage or adjacent thepatient during the surgery. In addition, right and left slavetelemanipulators 51 a and 51 b each may include a pull bar for pushingand pulling the telemanipulators within the operating room.

Moreover, a camera system may be used with surgical robot system 10. Forexample, a camera e.g., an endoscope, that is manipulated by theassistant situated at slave console 50 may be operated and/or held inposition at slave console 50. Accordingly, the camera system may includedisplay 21 mounted on master console 20 in a position that is easilyobservable by the surgeon during a surgical procedure. Display 21 maydisplay status information on the surgical robot system 10, and/ordisplay the surgical site captured by the endoscopic camera to surgeonin real-time.

Referring now to FIG. 2A, exemplary master console 20 is described. Asdescribed above, master console 20 includes right master telemanipulator22 a and left master telemanipulator 22 b. As left mastertelemanipulator 22 b may be a structurally mirrored version of rightmaster telemanipulator 22 a as illustrated, the description below ofright master telemanipulator 22 a applies also to left mastertelemanipulator 22 b.

Master telemanipulator 22 a includes a plurality of master links, e.g.,first master link 26, second master link 28, third master link 30, andfourth master link, e.g., guided master link 32, interconnected by aplurality of master joints, e.g., first master joint 25, second masterjoint 27, third master joint 29, fourth master joint 31, and fifthmaster joint 34. As shown in FIG. 1, handle portion 35 is connected tomaster telemanipulator 22 a via joint 34, and includes a plurality ofhandles links interconnected by a plurality of handle joints foroperating master telemanipulator 22 a. In addition, mastertelemanipulator 22 a includes a base portion having telescoping bases 23a and 23 b, and base cap 24 fixed atop telescoping bases 23 a and 23 b.Link 26 is rotatably coupled to base cap 24 via joint 25. Thus, link 26,and accordingly all the master joints and links distal to link 26, mayrotate relative to base cap 24 about axis 61 at joint 25. As shown inFIG. 1, link 28, and accordingly all the master joints and links distalto link 28, may rotate relative to link 26 about axis 62 at joint 27,link 30, and accordingly all the master joints and links distal to link30, may rotate relative to link 28 about axis63 at joint 29, and guidemaster link 32, and accordingly all the master joints and links distalto guided master link 32, may rotate relative to link 30 about axis 64at joint 31.

Master console 20 includes a plurality of sensors positioned withinmaster telemanipulator 22 a such that any movement applied to any masterlinks and joints may be sensed and transmitted to the control system,which will then execute instructions to cause one or more actuatorscoupled to slave console 50 to replicate the movement on correspondingslave link and joints of slave telemanipulator 51 a, as described infurther detail below with reference to FIG. 12.

Still referring to FIG. 2A, master telemanipulator 22 a includesmechanical constraint 33, which includes an opening within link 26 sizedand shaped to permit guided master link 32 to be positionedtherethrough, thereby constraining movements of master telemanipulator22 a about a pivot point at master telemanipulator 22 a. For example,mechanical constraint 33 ensures that, when master telemanipulator 22 ais actuated, guided master link 32 translates along longitudinal axis65. In addition, mechanical constraint 33 enables guided master link 32to rotate about axes 61 and 66 that are perpendicular to each other,creating a plane that intersects longitudinal axis65 at stationary pivotpoint P independently of the orientation of guided master link 32. As aresult, the slave telemanipulator produces corresponding movements,thereby virtually maintaining the pivot point of the mastertelemanipulator, for example, at the fixed incision point on a patientwhere a trocar passes into a patient's abdomen.

When surgical robot system 10 is positioned such that remotecenter-of-motion V is aligned with the patient incision, translationalmovement applied to handle portion 35 is replicated by the end-effectordisposed inside the patient. Because the end-effector replicates themovement applied to handle portion 35, this arrangement advantageouslyeliminates the fulcrum effect between the handle and end-effector.

In addition, master console 20 may include arm support 12, e.g., coupledto base cap 24, sized and shaped to permit the surgeon to rest thesurgeon's arms against the arm support during operation of masterconsole 20. Accordingly, arm support 12 remains static during operationof master telemanipulator 22 a. Master console 20 further may includeclutch 11, e.g., a foot pedal, that when actuated preventsmacro-synchronization of surgical robot system 10, as described infurther detail below.

Referring now to FIG. 2B, display 21 is described. Display 21 may have asimplistic design without text, utilizing only visible graphicalelements and LEDs, e.g., white, yellow, and red lights. For example,white light conveys that the component is functioning properly, yellowlight conveys that the surgeon has conducted an inappropriate action,and red conveys that there is an error with the component. As shown inFIG. 2B, display 21 graphically displays various components of slaveconsole 50 and the status thereof. Icon 21 a corresponds with thebooting of the system, icon 21 b corresponds with a system warning, icon21 h corresponds with the work limit being reached, and icon 21 jcorresponds with whether the respective slave telemanipulators of slaveconsole 50 are in a forward surgical workspace or a reverse surgicalworkspace, all of which may be invisible when not lit up, whereas allother icons have a visible graphical element even when not lit up. Icon21 c corresponds with homing, e.g., home configuration, of slave console50, icon 21 d corresponds with the status of instrument 82, icon 21 ecorresponds with the sterile interface of translation instrumentinterface 81, icon 21 f corresponds with macro-synchronization, icon 21g corresponds with micro-synchronization, and icon 21 i corresponds withwhether the wheels of slave console 50 are locked or unlocked, thefunctionality of all of which will be described in further detail below.As will be understood by a person having ordinary skill in the art,display 21 may be any display known in the art that may conveyinformation to the surgeon.

Referring now to FIGS. 3A-3C, master console 20 may be adjusted betweena seated configuration and a standing configuration via telescopingbases 23 a and 23 b. For example, as illustrated in FIG. 3A, masterconsole 20 may be adjusted to a seated configuration such thattelescoping bases 23 a and 23 b have a vertical height D₁. In thisseated configuration, the surgeon may be seated during operation ofmaster console 20. As illustrated in FIGS. 3B and 3C, master console 20may be adjusted to a standing configuration such that telescoping bases23 a and 23 b have a vertical height D₂. In this configuration, thesurgeon may be standing during operation of master console 20. Inaddition, the vertical height of telescoping bases 23 a and 23 _(b) maybe adjusted via an actuator positioned on master console 20, e.g., onmaster link 26. For example, the actuator may include up and downbuttons that when actuated, cause the vertical height of telescopingbases 23 a and 23 b to increase or decrease, respectively. As will beunderstood by a person having ordinary skill in the art, the verticalheight of telescoping bases 23 a and 23 b may be adjusted to anyvertical height between D₁ and D₂, as desired by the surgeon.

Referring now to FIG. 4, master console handle portion 35 is described.Master console handle portion 35 includes a plurality of handle links,e.g., handle link 36 and handle link 38, interconnected by a pluralityof handle joints, e.g., handle joint 37 and handle joint 39. Asillustrated in FIG. 4, handle link 36 is rotatably coupled to guidedmaster link 32 via joint 34, and accordingly may rotate relative toguided master link 32 about axis 67. In addition, handle link 38 isrotatably coupled to handle link 36 via handle joint 37, and accordinglymay rotate relative to handle link 36 about axis68. Moreover, handlegrip 40 may be removeably coupled to master console handle portion 35 atjoint 39, such that handle grip 40 may rotate relative to handle link 37about axis 69. As shown in FIG. 4, handle grip 40 may include fingerstrap 41 for engagement with the surgeon's fingers, e.g., thumb andindex finger.

Inward/outward movement of handle portion 35 causes guided master link32 to move inward/outward along longitudinal axis 65, the movement ofwhich is sensed by one or more sensors coupled to master telemanipulator22 a and transmitted to the control system, which then executesinstructions to cause one or more actuators coupled to slavetelemanipulator 51 a to cause the corresponding slave link to replicatethe inward/outward movement about virtual longitudinal axis W9.Similarly, upward/downward movement of handle portion 35 causes guidedmaster link to move upward/downward along longitudinal axis 66, themovement of which is sensed by one or more sensors coupled to mastertelemanipulator 22 a and transmitted to the control system, which thenexecutes instructions to cause one or more actuators coupled to slavetelemanipulator 51 a to cause the corresponding slave link to replicatethe upward/downward movement about virtual longitudinal axis ono.Finally, left/right movement of handle portion 35 causes guided masterlink to move left/right along longitudinal axis 61, the movement ofwhich is sensed by one or more sensors coupled to master telemanipulator22 a and transmitted to the control system, which then executesinstructions to cause one or more actuators coupled to slavetelemanipulator 51 a to cause the corresponding slave link to replicatethe left/right movement about virtual longitudinal axis W5.

Still referring to FIG. 4, movement applied at handle portion 35 ofmaster telemanipulator 22 a actuates the articulationdegrees-of-freedom, e.g., pitch and yaw, the actuationdegree-of-freedom, e.g., open/close, and the rotation degree-of-freedom,e.g., pronosupination, electromechanically via sensors, actuators, andthe control system. Master telemanipulator 22 a preferably includes oneor more sensors coupled to handle portion 35 for detecting motion ofhandle portion 35. As will be understood, the sensors may be any sensordesigned to detect rotational movement, such as magnetic-basedrotational sensors that includes a magnet on one side and a sensor onanother side to measure rotation by measuring angle and position. Thesensors are coupled to a control system for generating signalsindicative of the rotation measured by the sensors and transmitting thesignals to one or more actuators coupled to slave console 50, which mayreproduce movements applied on handle portion 35 to the end effector.For example, electrical cables may extend from handle portion 35 to thecontrol system, e.g., a unit containing control electronics, andadditional electrical cables may extend from the control system to theone or more actuators coupled to slave console 50.

As illustrated in FIG. 5A, handle grip 40 includes triggers 41 a, 41 bthat are biased toward an open configuration. Accordingly, triggers 41a, 41 b may be actuated to generate a signal that is transmitted via thecontrol system, which executes instructions that causes the actuatorscoupled to slave console 50 to actuate the end-effector to open/close.

Referring back to FIG. 4, handle grip 40 may be rotatable about handleaxis 69, such that rotation of the handle grip 40 is detected by asensor that generates and transmits a signal via the control system,which executes instructions that causes the actuators coupled to slaveconsole 50 to cause rotation of the end-effector in the pronosupinationdegree-of-freedom.

Handle portion 35 also is rotatable about handle axis 68, such that therotation about handle axis 68 is detected by a sensor, which generatesand transmits a signal via the control system, which executesinstructions that causes the actuators coupled to slave console 50 tocause movement of the end-effector in the yaw degree-of-freedom. Inaddition, handle portion 35 may be rotatable about handle axis 67, suchthat the rotation of handle portion 35 about handle axis 67 is detectedby a sensor, which generates and transmits a signal via the controlsystem, which executes instructions that causes the actuators coupled toslave console 50 to cause movement of the end-effector in the pitchdegree-of-freedom.

As illustrated in FIGS. 5B and 5C, handle grip 40 may be removeablycoupled to handle portion 35 of master telemanipulator 22 a via joint39. Accordingly, handle grip 40 may be removed between surgeries to besterilized, and reconnected to master telemanipulator 22 a just before asurgery. Thus, as the entirety of master console 20 may be covered witha sterile drape during operation of surgical robot system 10, handlegrip 40 will be sterile and may be connected to master console 20outside of the sterile drape. This permits the surgeon to directlycontact handle grip 40 without a physical barrier therebetween, therebyimproving tactile feedback and overall performance.

Referring now to FIGS. 6A-6C, handle grip 40 may be removeably coupledto handle portion 35 of master console 20 via a clip attachment. Asshown in FIGS. 6A-6C, spring 43 may be connected to joint 39 of handleportion 35 and clip portion 42 of handle grip 40 to preload theattachment to eliminate fixation backlash. In accordance with anotheraspect of the present invention, as shown in FIG. 7, handle grip 40′ maybe removeably coupled to handle portion 35′ of master console 20 via ascrew attachment. As shown in FIG. 7, screw portion 42′ of handle grip40′ having inner threaded portion 44 a may engage with outer threadedportion 44 b at joint 39′ of handle portion 35′, such that handle grip40′ is screwed onto handle portion 35′.

Referring now to FIGS. 8A-8C, actuation steps of handle grip 40 aredescribed. As illustrated in FIGS. 8B and 8C, handle grip 40 includesretractable piston 45 positioned within a central lumen of handle grip40. Retractable piston 45 is mechanically coupled to triggers 41 a, 41 bof handle grip 40 via connectors 46 a, 46 b, respectively. As shown inFIG. 8A, when triggers 41 a, 41 b are in a relaxed state, e.g., biasedtoward an open configuration, retractable piston 45 is completely withinthe central lumen of handle grip 40. As shown in FIGS. 8B and 8C, ashandle grip 40 is actuated, e.g., triggers 41 a, 41 b are pressed towardeach other, connectors 46 a, 46 b cause retractable piston 45 toprotrude out of the central lumen of handle grip 40. The movement ofretractable piston 45 beyond the central lumen of handle grip 40 may besensed by sensors within handle portion 35.

For example, as shown in FIGS. 9A and 9B, the portion of master consoleadjacent to where handle grip 40 is removeably coupled to handle portion35 may include one or more sensors 47 for sensing movement at handleportion 35. Accordingly, one or more sensors 47 may transmit a signal tothe control system indicating movement of retractable piston 45, and thecontrol system may execute instructions to cause one or more actuatorsto cause movement by the end-effector. This may serve as a fail-safebecause the control system will not instruct the actuators to causemovement by the end-effector without sensors 47 sensing movement ofretractable piston 45. For example, when triggers 41 a, 41 b of handlegrip 40 are in a relaxed state, no movement will be sensed due to smallincidental movements of triggers 41 a, 41 b until triggers 41 a, 41 bare purposefully actuated by the surgeon. Thus, triggers 41 a, 41 b mayhave to be actuated at least a pre-specified amount in order forretractable piston 45 to protrude beyond the central lumen of handlegrip 40. In addition, as illustrated in FIGS. 9A and 9B, handle portion35 may include spring 48 for pushing against retractable piston 45 tobias triggers 41 a, 41 b in an open configuration via connectors 46 a,46 b.

In accordance with another aspect of the present invention, asillustrated in FIGS. 10A-10C, handle grip 40″ may be removeably coupledto handle portion 35 of master telemanipulator 22 a. For example, handlegrip 40″ may have a pistol shape including a handle and trigger 49 forperforming a desired surgical task. As will be understood by a personhaving ordinary skill in the art, various shaped handle grips may beremoveably coupled to the master telemanipulator to actuate a desiredmovement by the end-effector of the slave telemanipulator. Accordingly,the handle grips may have an integrated identifier element, e.g., anRFID tag, such that the control system detects the identifier elementand identifies whether the handle grip is authorized for use withsurgical robot system 10.

Referring now to FIGS. 11A and 11B, slave console 50 is described. Asshown in FIG. 11A, slave console 50 includes right slave telemanipulator51 a and left slave telemanipulator 51 b. As left slave telemanipulator51 b may be a structurally mirrored version of right slavetelemanipulator 51 a as illustrated, the description below of rightslave telemanipulator 51 a applies also to left slave telemanipulator 51b.

As illustrated in FIG. 12, slave telemanipulator 51 a includes aplurality of slave links, e.g., first slave link 55, second slave link57, third slave link 59, fourth slave link, e.g., angulation link 61,fifth slave link 63, sixth slave link 65, seventh slave link 67, andeighth slave link, e.g., slave hub 69, interconnected by a plurality ofslave joints, e.g., first slave joint, e.g., proximal Scara joint 54,second slave joint, e.g., median Scara joint 56, third slave joint,e.g., distal Scara joint 58, fourth slave joint, e.g., angulation joint60, fifth slave joint, e.g., alpha joint 62, sixth slave joint, e.g.,beta joint 64, seventh slave joint, e.g., gamma joint 66, and eighthslave joint, e.g., theta joint 68. As shown in FIG. 12, translationalinstrument interface 81 is coupled to slave telemanipulator 51 a viatheta joint 68.

Translational instrument interface 81 may be constructed as described inU.S. Patent Application Publication No. 2018/0353252 to Chassot,assigned to the assignee of the instant application, the entire contentsof which are incorporated by reference herein. For example,translational instrument interface 81 includes slave hub 69 and asurgical instrument. As shown in FIG. 11B, slave hub 69 may be affixedto link 67 of slave telemanipulator 51 a. The surgical instrumentincludes the end-effector disposed at the distal end of the shaft of thesurgical instrument, and may be coupled to slave hub 69. For example,the end-effector may be removeably coupled to slave hub 69. A sterileinterface may be positioned between slave hub 69 and the surgicalinstrument. In addition, translational instrument interface 81 includesa translation transmission system that extends from one or moreactuators positioned within slave hub 69 to the components of theend-effector. For example, the end-effector includes a plurality ofend-effector links interconnected by a plurality of end-effector jointscoupled to the translation transmission system of translationalinstrument interface 81, such that actuation of the translationtransmission system by the one or more actuators causes movement of theend-effector via the plurality of end-effector links and joints.

In addition, slave telemanipulator 51 a includes base portion 52 havingand adjustable column, and slave support 53 fixed atop the adjustablecolumn. Link 55 is rotatably coupled to slave support 53 via proximalScara joint 54. Thus, link 55, and accordingly all the slave joints andlinks distal to link 55, may rotate relative to slave support 53 aboutaxis wi at proximal Scara joint 54. As shown in FIG. 12, link 57, andaccordingly all the slave joints and links distal to link 57, may rotaterelative to link 55 about axis ω₂ at median Scara joint 56, link 59, andaccordingly all the slave joints and links distal to link 59, may rotaterelative to link 57 about axis ω₃ at distal Scara joint 58, angulationlink 61, and according all the slave joints and links distal toangulation link 61, may rotate relative to link 59 about axis ω₄ atangulation joint 60, link 63, and accordingly all the slave joints andlinks distal to link 63, may rotate relative to angulation link 61 aboutalpha axis ω₅ at alpha joint 62, link 65, and accordingly all the slavejoints and links distal to link 65, may rotate relative to link 63 aboutbeta axis ω₆ at beta joint 64, link 67, and accordingly all the slavejoints and links distal to link 67, may rotate relative to link 65 aboutgamma axis ω₇ at gamma joint 66, and slave hub 69, and accordinglytranslational instrument interface 81 when translational instrumentinterface 81 is coupled to slave hub 69, may rotate relative to link 67about theta axis ω₈ at theta joint 68.

The column integrated into slave support 53 contains an actuator, e.g.,an electric motor, that allows for extending and retracting the column,thereby adjusting the height of all links distal to slave support 53relative to the ground. Alternatively, instead of a column integratedinto slave support 53, slave support 53 may include a mechanical linearguidance system having a counter-balance system based on acounter-weight, and an electric brake to block the vertical movement.Accordingly, when the electric brake is released, the vertical height ofall links distal to slave support 53 may be adjusted relative to theground. Proximal Scara joint 54, median Scara joint 56, and distal Scarajoint 58 each contain an electric brake that may block the movement ofthe corresponding joint when the respective brake is engaged and permitmanual movement of the respective joint when the respective brake isreleased. Angulation joint 60 contains an actuator, e.g., anelectromagnetic motor, that allows for adjustment of the angularposition of link 61 about link 59. Alpha joint 62, beta joint 64, gammajoint 66, and theta joint 68 are each linked to a dedicatedelectromagnetic motor and brake pair such that the control system mayadjust the angular position of each joint by applying a position commandto the respective motor, and stop any movement of the joint byactivating the respective brake.

As will be understood by a person having ordinary skill in the art,slave console 50 may include a plurality of sensors and master console20 may include a plurality of actuators such that movement applied atslave console 50 may cause movement to be applied at master console 20,thereby providing tactile feedback.

Referring now to FIG. 13, controller 70 is described. Controller 70 maybe a remote controller or a graphical user interface operatively coupledto the control system of surgical robot system 10, or a series ofactuators integrated into the left and right telemanipulator 51 a and 51b, respectively. Accordingly, controller 70 may include a plurality ofactuators, e.g., buttons, or a touchscreen interface whereby a user mayselect a plurality of options via touch. For example, controller 70 mayprovide a user with the option to select at least one of the followingcommands: Scara brake engagement and release, vertical adjustment ofslave console, vertical column brake release, home configuration,increase and decrease the forward angulation, flipping from forward toreverse gear or from reverse gear to forward gear, laparoscopicconfiguration, and park position configuration. Controller 70 isoperatively coupled to one or both slave controllers and/or the mastercontroller. Responsive to user input at controller 70, the respectiveslave controller executes instructions stored thereon to execute thecommand(s) explained below inputted by the user. Each slave console mayinclude its own dedicated controller 70 or a common controller 70 may beused for both slave consoles.

For example, as illustrated in FIGS. 14A-14E, controller 70 may permit auser to release the brakes in proximal Scara joint 54, median Scarajoint 56, and distal Scara joint 56 so that the surgeon may manuallyreposition the slave arm horizontally by grabbing, holding andpushing/pulling the slave arm links distal to proximal Scara joint 54while slave support 53 of the slave telemanipulator remains stationary.Specifically, during Scara movement, slave links 55, 57, 59 arepermitted to move about axes on, 0)2, 0)3, at joints 54, 56, and 58,while slave support 53 of the slave telemanipulator remains stationary,and while the slave joints and link distal to slave link 59 are fixedrelative to slave link 59. Accordingly, the user may adjust the distalend of the slave telemanipulator, e.g., slave hub 69, to a desiredposition over the patient undergoing surgery.

As illustrated in FIGS. 15A-15C, controller 70 may permit a user toselect a vertical adjustment of slave console command whereby thecontrol system will execute instructions to cause the actuator, e.g.,motor, coupled to the column in slave support 53 to extend or retract.Specifically, during vertical adjustment of the slave telemanipulator,the relative distance between slave link 55 and the top surface of baseportion 52 of the slave telemanipulator may be adjusted. For example, asshown in FIG. 15A, the vertical distance between slave link 55 and thetop surface of base portion 52 of the slave telemanipulator is H₁, asshown in FIG. 15B, the vertical distance between slave link 55 and thetop surface of base portion 52 of the slave telemanipulator is H₂, andas shown in FIG. 15C, the vertical distance between slave link 55 andthe top surface of base portion 52 of the slave telemanipulator is H₃.Accordingly, the user may adjust the relative distance between slavelink 55 and the top surface of base portion 52 of the slavetelemanipulator to a desired height over the patient undergoing surgery.In the embodiment where the slave console includes a mechanical linearguidance system having a counter-balance system based on acounter-weight, controller 70 may permit a user to select a verticaladjustment of slave console command whereby the control system willexecute instructions to cause an electric brake in the column to bereleased so that the mechanically counter-balanced linear guidancesystem may move up or down, thereby adjusting the relative distancebetween slave link 55 and the top surface of base portion 52 of theslave telemanipulator to a desired height over the patient undergoingsurgery.

As illustrated in FIG. 16, controller 70 may permit a user to select ahome configuration command whereby the control system will executeinstructions to cause the actuators coupled to beta joint 64, gammajoint 66, and theta joint 68 to move the slave links and joints to aretracted position such that slave hub 69 of the slave telemanipulatoris in a desirable position for positioning the shaft of translationalinstrument interface 81 within a trocar within the patient undergoingsurgery. In the home position, slave hub 69 will be positioned relativeto the trocar within the patient such that an instrument 82 may beinserted through and coupled to slave hub 69, such that instrument tip84 will slide into, but not pass through the trocar, hence permittingthe surgeon to insert the instrument safely and without the need forsupervising the distal end of the trocar with the help of an endoscope.

In addition, controller 70 may permit a user to select an angulationcommand whereby the control system will execute instructions to causethe actuator coupled to angulation joint 60 to adjust the angulation ofangulation link 61 about axis w4 at angulation joint 60 to a desiredangulation angle, e.g., between zero and 45-degrees relative to base 52of slave telemanipulator 51 a. Specifically, when the angulation commandis actuated, angulation link 61, and accordingly all the slave links andjoints distal to angulation link 61, will rotated about axis 0)4 atangulation joint 60, while slave link 59 and all the slave links andjoints proximal to slave link 59, and base portion 52 of the slavetelemanipulator remains stationary. By adjusting the angulation angle ofthe slave telemanipulator, the angle of the surgical workspace of theslave telemanipulator will be adjusted, providing more access by thesurgeon to the patient via translational instrument interface 81.

For example, FIGS. 17A-17D illustrate movement of translationalinstrument interface 81 coupled to slave telemanipulator 51 a duringzero-degree angulation of the slave console. As shown in FIGS. 17A-17D,angulation link 61, and accordingly angulation axiscos, are parallelwith the longitudinal axis of base 52 of slave telemanipulator 51 a, andperpendicular with the ground floor. During operation of slavetelemanipulator 51 a, the control system only executes instructions tocause the actuators coupled to slave console 20 to apply movement to theslave links and joints distal to angulation link 61. Accordingly, asshown in FIGS. 18A-18D, translational instrument interface 81 of slavetelemanipulator 51 a has forward surgical workspace FSW, e.g., theextent to which translational instrument interface 81 can reach in aforward configuration during zero-degree angulation of the slaveconsole. FIG. 18E is a back view of forward surgical workspace FSW ofthe slave console of FIGS. 18A-18D.

FIGS. 19A-19C illustrate movement of translational instrument interface81 coupled to slave telemanipulator 51 a during 20-degree angulation ofthe slave console. As shown in FIGS. 19A, angulation link 61, andaccordingly angulation axiscos, is adjusted to a 20-degree anglerelative to the longitudinal axis of base 52 of slave telemanipulator 51a. During operation of slave telemanipulator 51 a, the control systemonly executes instructions to cause the actuators coupled to slaveconsole 20 to apply movement to the slave links and joints distal toangulation link 61. Accordingly, as shown in FIGS. 19B, translationalinstrument interface 81 of slave telemanipulator 51 a has forwardsurgical workspace FSW, e.g., the extent to which translationalinstrument interface 81 can reach in a forward configuration during20-degree angulation of the slave console. FIG. 19C is a back view offorward surgical workspace FSW of the slave console of FIG. 19B during20-degree angulation of the slave console.

FIGS. 20A-20C illustrate movement of translational instrument interface81 coupled to slave telemanipulator 51 a during 40-degree angulation ofthe slave console. As shown in FIGS. 20A, angulation link 61, andaccordingly angulation axis W5, is adjusted to a 40-degree anglerelative to the longitudinal axis of base 52 of slave telemanipulator 51a. During operation of slave telemanipulator 51 a, the control systemonly executes instructions to cause the actuators coupled to slaveconsole 20 to apply movement to the slave links and joints distal toangulation link 61. Accordingly, as shown in FIGS. 20B, translationalinstrument interface 81 of slave telemanipulator 51 a has forwardsurgical workspace FSW, e.g., the extent to which translationalinstrument interface 81 can reach in a forward configuration during40-degree angulation of the slave console. FIG. 20C is a back view offorward surgical workspace FSW of the slave console of FIG. 19B during40-degree angulation of the slave console.

As illustrated in FIGS. 21A-21J, controller 70 may permit a user toselect a flipping command whereby the control system will executeinstructions to cause the plurality of actuators coupled to the slaveconsole to move slave telemanipulator 51 a between a forward surgicalworkspace and a reverse surgical workspace. For example, the controlsystem may cause the plurality of actuators coupled to the slave consoleto invert slave telemanipulator 51 a from a forward surgical workspaceto a reverse surgical workspace, and vice versa. Specifically, duringactuation of the flipping command, link 65, and accordingly all slavelinks and slave joints distal to link 65, are rotated about beta joint64 of slave telemanipulator 51 a. In addition, as link 65 rotates aboutbeta joint 64, link 67 rotates relative to link 65 at gamma joint 66,and slave hub 69 rotates relative to link 67 about theta joint 68, untilslave telemanipulator 51 a is in a reverse surgical workspaceconfiguration. As illustrated in FIGS. 22B-22H, translational instrumentinterface 81 is removed from slave hub 69 prior to actuation of theflipping command to prevent translational instrument interface 81 frominjury the patient. As slave telemanipulator 51 a is able to flipbetween a forward surgical workspace and a reverse surgical workspace bysimply removing translational instrument interface 81 and actuating theflipping command without having to unlock slave telemanipulator 51 a andmove it about the operating room, and without having to actuate theScara brake release command or the vertical adjustment of slave consolecommand, the user will save a lot of time and be able to quicklycontinue operating on the patient in a different surgical workspace.

Referring now to FIGS. 21K and 21L, a schematic of the master consoleand slave console having a forward surgical workspace and a reversesurgical workspace, respectively, is provided. As shown in FIG. 21K,when the telemanipulators of slave console 50 have a forward surgicalworkspace, master controller 2 of master console 20 is programmed suchthat right master telemanipulator 22 a communicates with right slavetelemanipulator 51 a, and left master telemanipulator 22 b communicateswith left slave telemanipulator 51 b. Accordingly, master controller 2may receive signals indicative of movement applied at right mastertelemanipulator 22 a by the one or more sensors of master console 20,and execute instructions stored thereon to perform coordinate transformsnecessary to activate the one or more actuators of slave console 50,send the processed signals to respective slave controllers 4 a thatexecute instructions stored thereon to move right slave telemanipulator51 a in a manner corresponding to movement of right mastertelemanipulator 22 a based on the processed signals. Similarly, mastercontroller 2 may receive signals indicative of movement applied at leftmaster telemanipulator 22 b by the one or more sensors of master console20, and execute instructions stored thereon to perform coordinatetransforms necessary to activate the one or more actuators of slaveconsole 50, send the processed signals to respective slave controllers 4b that execute instructions stored thereon to move left slavetelemanipulator 51 b in a manner corresponding to movement of leftmaster telemanipulator 22 b based on the processed signals.

As shown in FIG. 21L, when the telemanipulators of slave console 50 havea reverse surgical workspace, master controller 2 of master console 20behaves as a switch board and is programmed such that right mastertelemanipulator 22 a communicates with left slave telemanipulator 51 b,and left master telemanipulator 22 b communicates with right slavetelemanipulator 51 a. This is necessary so that the surgeon positionedat master console 20 and viewing the surgery site via display 21 mayoperate what appears to the surgeon as the “right” slave telemanipulator(left slave telemanipulator 51 b in the reverse surgical workspace) withright master telemanipulator 22 a and what appears to the surgeon as the“left” slave telemanipulator (right slave telemanipulator 51 a in thereverse surgical workspace) with left master telemanipulator 22 a.Accordingly, master controller 2 may receive signals indicative ofmovement applied at right master telemanipulator 22 a by the one or moresensors of master console 20, and execute instructions stored thereon toperform coordinate transforms necessary to activate the one or moreactuators of slave console 50, send the processed signals to respectiveslave controllers 4 b that execute instructions stored thereon to moveleft slave telemanipulator 51 b in a manner corresponding to movement ofright master telemanipulator 22 a based on the processed signals.Similarly, master controller 2 may receive signals indicative ofmovement applied at left master telemanipulator 22 b by the one or moresensors of master console 20, and execute instructions stored thereon toperform coordinate transforms necessary to activate the one or moreactuators of slave console 50, send the processed signals to respectiveslave controllers 4 a that execute instructions stored thereon to moveright slave telemanipulator 51 a in a manner corresponding to movementof left master telemanipulator 22 b based on the processed signals.

Thus, in the forward surgical workspace configuration, master controller2 communicates with right slave controller 4 a to cause right slavetelemanipulator 51 a to move responsive to movement at right mastertelemanipulator 22 a and master controller 2 communicates with leftslave controller 4 b to cause left slave telemanipulator 51 b to moveresponsive to movement at left master telemanipulator 22 b.Additionally, in the reverse surgical workspace configuration, mastercontroller 2 communicates with left slave controller 4 b to cause leftslave telemanipulator 51 b to move responsive to movement at rightmaster telemanipulator 22 a and master controller 2 communicates withright slave controller 4 a to cause right slave telemanipulator 51 a tomove responsive to movement at left master telemanipulator 22 b.

FIG. 22A illustrates slave telemanipulator 51 a in a reverseconfiguration during zero-degree angulation of the slave console, FIGS.22B illustrates slave telemanipulator 51 a in a reverse configurationduring 20-degree angulation of the slave console, and FIG. 22Cillustrates slave telemanipulator 51 a in a reverse configuration during40-degree angulation of the slave console. In addition, as shown inFIGS. 23A-23C, translational instrument interface 81 of slavetelemanipulator 51 a has reverse surgical workspace RSW, e.g., theextent to which translational instrument interface 81 can reach in areverse configuration during zero-degree angulation, 20-degreeangulation, and 40-degree angulation, respectively, of the slaveconsole.

As illustrated in FIGS. 24A-24D, controller 70 may permit a user toselect a laparoscopic configuration command whereby the control systemwill execute instructions to cause the plurality of actuators coupled tothe slave console to move slave hub 69 away from the patient undergoingsurgery so that the surgeon may quickly and safely move from masterconsole 20 to the surgical site on the patient to manually performlaparoscopic tasks on the patient. Specifically, actuation of thelaparoscopic configuration command causes link 63, and accordingly allthe slave links and joints distal to link 63, to rotate about alpha axisW3 at joint 62 while angulation link 61, and accordingly all the slavelinks and joints proximal to angulation link 61 including base 52 ofslave telemanipulator 51 a remain stationary, until slave hub 69 isfacing away from the patient as shown in FIG. 24D. Accordingly,translational instrument interface 81 must be removed from slave hub 69prior to actuation of the laparoscopic configuration command.

Referring now to FIGS. 25-30, exemplary method 90 for using of surgicalrobot system 10 via the control system is described. As will beunderstood by one skilled in the art, the steps of the methods describedherein may be executed by one or more processors of the control system(e.g., at the master controller, the first slave controller, and/or thesecond slave controller) that execute instructions stored in one or morememory components responsive to user input. As shown in FIG. 25, at step91, system 10 is powered on. At step 92, slave console 50 is prepared tobe ready for operating on the patient undergoing surgery as furtherillustrated in FIG. 27, and at step 93, master console 20 is positionedto the surgeon's desired configuration during operation as furtherillustrated in FIG. 26.

For example, FIG. 26 illustrates step 93 of positioning master console20 to the surgeon's desired configuration. Master console 20 may bemoved about the operating room via the wheels at its base while thewheels are unlocked. Upon reaching the desired location within theoperating room, the wheel locks are activated to keep master console 20in place. As shown in FIG. 26, at step 93A, the master telemanipulatorsare stationary and telescoping bases 23 a, 23 b have an initial height.A controller operatively coupled to master console 20, e.g., a button,may then be actuated to adjust the height of telescoping bases 23 a, 23b, e.g., to increase or decrease the height of telescoping bases 23 a,23 b, until master console 20 is at the surgeon's desired height at step93B. For example, master console 20 may be adjusted to a seatedconfiguration where the surgeon may be seated during operation of masterconsole 20, or a standing configuration where the surgeon may bestanding during operation of master console 20. Accordingly, thecontroller may be actuated to return master console 20 to the initialheight, e.g., for storage purposes.

Referring now to FIG. 27, step 92 of preparation of slave console 50 isdescribed. As shown in FIG. 27, at step 92A, the wheel locks of theslave telemanipulator are disengaged such that slave console 50 may bemoved about the operating room to the desired location relative to thepatient. The wheel locks can only be disengaged when no instrument 82 isinserted into slave hub 69 so as to avoid injuring the patient. Asmultiple slave telemanipulators may be used, each slave telemanipulatoris positioned during step 92A. When slave console 50 is in the desiredposition within the operating room adjacent the patient undergoingsurgery, the wheel locks of slave console 50 are activated at step 92Bsuch that slave console 50 is prevented from further movement about theoperating room via its wheels. Accordingly, the wheel locks may bedisengaged again at step 92A if slave console 50 needs to be moved to adifferent desired position.

At step 92C, the Scara brake release command has not been actuated andScara brakes of slave console 50 are on. At step 92D, the Scara brakerelease command may be actuated by the user to position the distal endof the slave telemanipulator, e.g., the slave links distal to link 59,at a desired position over the patient undergoing surgery. Specifically,upon actuation of the Scara brake release command, slave links 55, 57,59 are permitted to move about axes on, W2, W3, at joints 54, 56, and58, while slave support 53 of the slave telemanipulator remainsstationary, and while the slave joints and link distal to slave link 59are fixed relative to slave link 59. When the distal end of the slavetelemanipulator is in the desired positioned over the patient, actuationof the Scara brake release command ceases at step 92C. In addition, asdescribed above with reference to FIGS. 15A-15C, the vertical height ofthe slave telemanipulators may be adjusted such that the distal end ofthe slave telemanipulator is at a desired height relative to the trocarwithin the patient. The Scara brake release command can only be enabledwhen no instrument 82 is present in slave hub 69 so as to avoid injuringthe patient.

Referring again to FIG. 27, at step 92E, angulation link 61 of the slavetelemanipulator is stationary relative to slave link 59. For example,the slave telemanipulator may initially have an angulation angle of zerodegrees. At step 92F, the angulation command may be actuated to adjustthe angulation of angulation link 61 about axis o at angulation joint 60to a desired angulation angle, e.g., between zero and 45-degreesrelative to base 52 of slave telemanipulator 51 a. Specifically, uponactuation of the angulation command, angulation link 61, and accordinglyall the slave links and joints distal to angulation link 61, willrotated about axis ω₄ at angulation joint 60, while slave link 59 andall the slave links and joints proximal to slave link 59, and baseportion 52 of the slave telemanipulator remains stationary. When thedesired angle of angulation of the slave telemanipulator is achieved,actuation of the angulation command ceases at step 92E such thatangulation link 61 of the slave telemanipulator is stationary relativeto slave link 59. The angulation command may have two buttons, one toincrease and another one to decrease the angulation.

At step 92G, the slave telemanipulator has a forward surgical workspace,or alternatively, at step 92H, the slave telemanipulator has a reversesurgical workspace. During both steps 92G and 92H, instrument 82 cannotbe in slave hub 69. If the slave telemanipulator has a forward surgicalworkspace at step 92G, and the user desires a reverse surgicalworkspace, the flipping command may be actuated to invert slavetelemanipulator 51 a from a forward surgical workspace to a reversesurgical workspace. Specifically, upon actuation of the flippingcommand, link 65, and accordingly all slave links and slave jointsdistal to link 65, are rotated about beta joint 64 of slavetelemanipulator 51 a. In addition, as link 65 rotates about beta joint64, link 67 rotates relative to link 65 at gamma joint 66, and slave hub69 rotates relative to link 67 about theta joint 68, until slavetelemanipulator 51 a is in a reverse surgical workspace configuration.Similarly, if the slave telemanipulator has a reverse surgical workspaceat step 92H, and the user desires a forward surgical workspace, theflipping command may be actuated to invert slave telemanipulator 51 afrom a forward surgical workspace to a reverse surgical workspace.

At step 921, translational instrument interface 81 is not coupled toslave hub 69 of the slave telemanipulator. At step 92J, a temporaryincision pointer may be removeably coupled to the slave telemanipulator.For example, the temporary incision pointer is removeably coupled to theslave telemanipulator such that it points to virtual remotecenter-of-motion V located at a predetermined point on axis ω₅, suchthat virtual remote center-of-motion V may be brought in coincidencewith the surgical incision point, reducing trauma to the patient andimproving cosmetic outcomes of the surgery. The temporary incisionpointer may be removed prior to installation of the translationalinstrument interface 81 if necessary. During preparation step 92,instrument 82 should not be coupled to slave hub 69 of the slavetelemanipulator. Thus, if instrument 82 is coupled to slave hub 69 ofthe slave telemanipulator, at step 92K, the control system will preventfurther actions until translational instrument interface 81 is removed.

At step 92L, the slave links and joints distal to link 61 of the slavetelemanipulator may be in any position. Accordingly, at step 92M, thehome configuration command may be actuated to move the slave links andjoints to a retracted position such that slave hub 69 of the slavetelemanipulator is in a desirable position for positioning instrumenttip 84 within a trocar within the patient undergoing surgery. At step92N, the slave telemanipulator is in the home position, wherein slavehub 69 is positioned relative to the trocar within the patient such thatinstrument 82 may be inserted through and coupled to slave hub 69, andthe instrument tip 84 will slide into, but not pass through the trocar.

At step 920, the laparoscopic configuration command may be actuated tomove slave hub 69 away from the patient undergoing surgery so that thesurgeon may quickly and safely move from master console 20 to thesurgical site on the patient to manually perform laparoscopic tasks onthe patient. Specifically, upon actuation of the laparoscopicconfiguration command, link 63, and accordingly all the slave links andjoints distal to link 63, to rotate about alpha axis 0)3 at joint 62while angulation link 61, and accordingly all the slave links and jointsproximal to angulation link 61 including base 52 of slavetelemanipulator 51 a remain stationary, until slave hub 69 is facingaway from the patient. At step 92P, slave hub 69 is in the retractedposition.

At step 92Q, the sterile interface of translational instrument interface81 is not coupled to slave hub 69 of the slave telemanipulator. At step92R, the sterile interface is coupled to the slave hub, and the controlsystem determines whether the sterile interface is identified, e.g., byreading an RFID tag integrated into the sterile interface. If thesterile interface is not identified, at step 92S, the control systemawaits removal of the sterile interface until the sterile interface isdecoupled from slave hub 69 at step 92Q. If the sterile interface isidentified, the sterile interface is successfully installed at step 92T.

At step 92U, the park position command may be actuated to move slavetelemanipulator 51 b into a position suitable for transportation andstorage. Specifically, upon actuation of the park position command, thevertical column in slave support 53 retracts to a minimum height, theScara brakes release to fold the Scara arm into a folded position, theangulation returns to zero-degree angulation, and the joints distal tojoint 62 move to fold the slave arm into a compact position. Surgicalrobot system 10 may be powered off if necessary after step 92.

If surgical robot system 10 is not powered off after step 92, at step94, the control system determines whether the sterile interface has beensuccessfully installed and whether the floor lock is activated. If it isdetermined that either the sterile interface has not been successfullyinstalled or that the floor lock is disengaged, surgical robot system 10must return to preparation step 92 to rectify the above. If it isdetermined at step 94 that the sterile interface has been successfullyinstalled and that the floor lock is activated, surgical robot system 10may proceed to step 95.

At step 95, surgical robot system is ready for instrument 82 as shown inFIG. 28. For example, at step 95A, the control system of slave console50 waits for instrument 82 until instrument 82 is coupled to slave hub69 of the slave telemanipulator. Accordingly, an instrument 82 isselected and inserted within slave hub 69. To ensure that the instrumentdoesn't fall out of the slave hub, the user may mechanically lock theinstrument into slave hub 69 by rotating the proximal end of theinstrument. Slave hub 69 has an integrated sensor to detect whether theinstrument is locked. At step 95B, sensors positioned within slave hub69 read out an identifier element integrated with the selectedinstrument, e.g., an RFID tag, where the RFID tag containsidentification information of the selected instrument. At step 95C, thecontrol system determines whether the selected instrument is authorizedbased on the detection of the RFID tag. If the selected instrument isnot authorized, the control system waits until it is removed at step95D. When the unauthorized instrument is removed, step 95D returns tostep 95A. If the selected instrument is authorized and locked withinslave hub 69 of the slave telemanipulator at step 95E, method 90 mayproceed to step 96. If at any time during step 95 the sterile interfaceis removed, the floor lock is disengaged, the flipping command isactuated, the Scara brake release command is actuated, the homeconfiguration command is actuated, or the incision pointer is inserted,method 90 may return to preparation step 92.

At step 96, surgical robot system 10 is ready for operation. As shown inFIG. 29, at step 96A, the control system verifies that instrument 82 iscoupled to slave hub 69 of the slave telemanipulator. At step 96B, thecontrol system detects when the surgeon grabs handle grip 40 of handleportion 35. As shown in FIG. 9A and 9B, sensors within the handle maydetect that the surgeon has grabbed the handle. At step 96C, clutch 11is actuated to prepare the control system for macro-synchronization asdescribed in step 97A.

As shown in FIG. 30, surgical robot system 10 may now be operated. Forexample, at step 97A, surgical robot system 10 is in amacro-synchronization state, but not in a micro-synchronization state.In the macro-synchronization state, translational macro-movementsapplied at master console 20 will be sensed and transmitted to thecontrol system, which instructs the actuators coupled to slave console50 to cause the corresponding slave links and joints to move in a mannerso that the macro-movements (i.e. up/down, left/right, in/out) ofinstrument tip 84 corresponds to the macro-movements of the handle atthe master console 20. However, in the unsynchronized macro state, thecontrol system does not cause macro-movements applied at master console20 to be made in a corresponding manner at slave console 50. In themicro-synchronization state, micro-movements applied at handle portion35 of master console 20 will be sensed and transmitted to the controlsystem, which instructs the actuators coupled to slave console 50 tocause the instrument tip 84 move in a manner corresponding to thosemicro-movements applied at handle portion 35 of master console 20.However, in the unsynchronized micro state, the control system does notcause micro-movements applied at master console 20/handle portion 35 tobe made in a corresponding manner at slave console 50/end-effector.Thus, at step 97A, translational macro-movements are replicated, butmicro-movements are unsynchronized. Clutch 11 may be actuated totransition surgical robot system 10 to unsynchronized macro state atstep 97B where translation macro-movements may be prevented by masterconsole 20, and thus not replicated by slave console 50. For example,clutch 11 may be a foot pedal that when stepped on, maintains surgicalrobot system 10 in the unsynchronized macro state. Upon release ofclutch 11, surgical robot system 10 returns to the macro-synchronizationstate at step 97A.

In addition, the control system may be programmed to detect an actuationpattern by handle portion 35 such that micro-movements at handle portion35 are not replicated by the end-effector unless the control systemdetects the actuation pattern. For example, the actuation pattern mayinclude a quick, double actuation of handle grip 40. Thus, when the userpresses handle grip 40 twice repeatedly at step 97C, the control systemdetects the actuation pattern, and surgical robot system 10 is in amicro-synchronization state where micro-movements at handle portion 35will be replicated by the end-effector. When transitioning from anunsynchronized micro state to a micro-synchronization state, the controlsystem executes instructions to cause the micro-position of instrumenttip 84 to have the same spatial orientation relative to the instrumentshaft 82 as the spatial orientation of handle portion 35 relative tocorresponding link 32 of master telemanipulator 22 a. At step 97D,surgical robot system 10 is fully in both a macro-synchronization stateand a micro-synchronization state, e.g., when the end-effector is in thetarget position for the operation, and the surgeon can use surgicalrobot system 10 to perform surgical tasks. Upon actuating clutch 11, atstep 97E, surgical robot system 10 is in a micro-synchronization state,but in the unsynchronized macro state.

In accordance with another aspect of the present invention, a remotelyactuated surgical robot system having hybrid telemanipulators, which maybe used in minimally invasive surgical procedures or in otherapplications, constructed in accordance with the principles of thepresent invention, is described herein.

Referring to FIGS. 31A and 31B, exemplary remotely actuated surgicalrobot system 100 having hybrid telemanipulators is described. Surgicalrobot system 100 illustratively is affixed atop moveable cart 101, towhich the hybrid telemanipulators also may be mounted for mobility andease of transport within an operating room. Surgical robot system 100includes master region 400, where a surgeon may be situated to operatesystem 100, and remote slave region 500 in proximity to the sterilezone, where a patient to be operated upon may be positioned. As shown inFIG. 31B, the operating surgeon preferably is seated with ready accessto master region 400, while another surgeon or assistant may be situatednear slave region 500, which is positioned over a patient. In theembodiment of FIGS. 31A and 31B, master region 400 is situated laterallyadjacent to slave region 500. In addition, camera system 102 may be usedwith surgical robot system 100, e.g., an endoscope that is manipulatedby the assistant situated at slave region 500 may be operate and/or heldin position as shown in FIG. 31B. Camera system 102 also may includedisplay 103 for displaying the surgical site captured by camera 102 tothe surgeon in real-time. Display 103 may be mounted to master region400, or anywhere in proximity to master region 400 that is easilyobservable by the surgeon during a surgical procedure.

Referring again to FIG. 31A, system 100 includes two hybridtelemanipulators 104 and 105, including left hybrid telemanipulator 104that is manipulated by the surgeon's left hand, and right hybridtelemanipulator 105 that is manipulated by the surgeon's right hand.Hybrid telemanipulators 104 and 105 may be operated simultaneously andindependently from the other, e.g., by the surgeon's left and righthands. Preferably, the teleoperated remotely actuated surgical robotsystem 100 is optimized for use in surgical procedures.

Each hybrid telemanipulator provides input to a master-slaveconfiguration, in which a slave unit, made of a plurality of rigid slavelinks and slave joints, is driven kinematically by a master unit, madeof a plurality of rigid master links and master joints. For example,left hybrid telemanipulator 104 includes master unit 401 andcorresponding slave unit 501, and right hybrid telemanipulator 105includes master unit 402 and corresponding slave unit 502. Master units401 and 402 are disposed within master region 400 of system 100, whileslave units 501 and 502 are within slave region 500 of system 100.Preferably, slave units 501 and 502 mimics the movement of thecorresponding portions of master units 401 and 402, respectively,without deviating, during operation of the device, from a remotecenter-of-motion, as described in further detail below.

Still referring to FIG. 31A, teleoperated surgical instrument 106, e.g.,translational instrument interface, having end effector 107 is coupledto the distal end of slave unit 501, and a handle is coupled to thedistal end of master unit 401 such that movement applied to the handleinduces a corresponding micro-movement of end-effector 107 via aprocessor-driven control system. For example, the control system mayreceive a signal indicative of movement applied at the handle by one ormore sensors coupled to the handle, and perform coordinate transformsnecessary to activate one or more actuators operatively coupled toend-effector 107 to replicate a corresponding movement of the endeffector. Slave instrument 106 of the translational instrument interfacemay be removeably attached to and operated by slave unit 501, such thatthe translation degrees-of-freedom, e.g., left/right, upward/downward,inward/outward, are actuated by direct mechanical coupling, whereas thearticulation degrees-of-freedom, e.g., pitch and yaw, the actuationdegrees-of-freedom, e.g., open/close, and the rotationdegree-of-freedom, e.g., pronosupination, are electromechanicallyreplicated via sensors, actuators, and a control system as described infurther detail below.

Referring now to FIGS. 32A and 32B, the mechanisms of exemplary remotelyactuated surgical robot system 100 having hybrid telemanipulators areillustrated, in which the external covers depicted in FIGS. 31 areomitted for clarity. In FIGS. 32A and 32B, mechanical transmission 300is arranged to directly couple slave unit 501 with master unit 401, suchthat translational macro-movement applied to the plurality of masterjoints of master unit 401 is replicated by corresponding respectivejoints of the plurality of slave joints of slave unit 501. Likewise,mechanical transmission 300 also directly couples slave unit 502 withmaster unit 402, such that translational macro-movement applied to theplurality of master joints of master unit 402 is replicated bycorresponding respective joints of the plurality of slave joints ofslave unit 502. Transmission 300 illustratively includes one or morecables 301 routed via one or more pulleys from master unit 401 to slaveunit 501, and one or more cables 303 routed via one or more pulleys frommaster unit 402 to slave unit 502, for controlling one of fourdegrees-of-freedom of slave unit 501 and 502. Mechanical constraint 200of master unit 401 constrains movement of master unit 401 by removing adegree-of-freedom of motion, thereby limiting movement in threetranslational degrees-of-freedom, e.g., left/right, upward/downward,inward/outward.

For example, one or more cables 301 may form one or more closed loopsbeginning at pulley P1 coupled to master unit 401, and extending throughpulleys P2, P3, P4, P5, P6, tensioning system 302, pulley P7, and aroundpulley P8 coupled to slave unit 501, and extending back through pulleyP7, tensioning system 302, pulleys P6, P5, P4, P3, P2, and ending atpulley P1. Thus, rotation of pulley P1 clockwise or counter-clockwisecauses a cable of one or more cables 301 to rotate pulley P8, therebyactuating a slave unit 501 in one of four degrees-of-freedoms.Mechanical constraint 200 of master unit 401, however, constrainsmovement of master unit 401 by removing one degree-of-freedom of motion,thereby limiting movement of slave unit 501 to three translationaldegrees-of-freedom, e.g., left/right, upward/downward, inward/outward.Each of pulleys P1, P2, P3, P4, P5, P6, P7, and P8 may include a numberof individual pulleys corresponding to the number of degrees-of-freedomof motion actuable of slave unit 501 by master unit 401. Similarly, oneor more cables 301 may include a number of closed cable loopscorresponding to the number of degrees-of-freedom of motion actuable ofslave unit 501 by master unit 401.

Similarly, one or more cables 303 may form one or more correspondingclosed loops beginning at pulley P9, coupled to master unit 402, andextending through tensioning system 304, pulleys P10, P11, P12, P13,P14, and around pulley P15 coupled to slave unit 502, and extending backthrough pulleys P14, P13, P12, P11, P10, tensioning system 304, andending at pulley P9. In this manner, rotation of pulley P9 clockwise orcounter-clockwise may cause a cable of one or more cables 303 to rotatepulley P15, thereby actuating a slave unit 502 in one of fourdegrees-of-freedoms. Mechanical constraint 201 of master unit 402 (seeFIG. 32A) likewise constrains movement of master unit 402 by removing adegree-of-freedom of motion, thereby limiting movement of slave unit 502to three translational degrees-of-freedom, e.g., left/right,upward/downward, inward/outward. Each of pulleys P9, P10, P11, P12, P13,P14, and P15 may include a number of individual pulleys corresponding tothe number of degrees-of-freedom of motion actuable of slave unit 502 bymaster unit 402. Similarly, one or more cables 303 may include a numberof closed cable loops corresponding to the number of degrees-of-freedomof motion actuable of slave unit 502 by master unit 402.

As will be understood by a person having ordinary skill in the art, thenumber of pulleys P2-P7 employed to route cables 301 between pulleys P1and P8, and the number of pulleys P10-P14 employed to route cables 303between pulleys P9 and P15 will depend on the construction of the rightand left hybrid telemanipulators, respectively.

Referring now to FIG. 33, one or more cables 301 of mechanicaltransmission 300 pass through tensioning system 302, and one or morecables 303 passes through tensioning system 304. Tensioning system 302is designed to apply a predetermined tension force to cables 301, whiletensioning system 304 is designed to apply a predetermined tension forceto cables 303. For example, tensioning system 302 may include pulley P16coupled to pulley P17 via tension link 305, and pulley P18 coupled topulley P19 via tension link 306. Tension link 305 is adjustably androtatably coupled to tension link 306 about a vertical axis runningthrough axle 307, such that a predetermined tension force is applied tocables 301 by pulleys P16, P17, P18, and P19. In addition, tensioningsystem 302 may be used to calibrate mechanical transmission 300, therebyensuring that the angles of corresponding master and slave joints areidentical. Tensioning system 304 may be identical in structure totensioning system 302.

Also in FIG. 33, pulleys P11, P12, and P13 of the mechanicaltransmission of the right hybrid telemanipulator are coupled to slavelink 308, which is rotatably coupled to positioning system 310 via slavelink 309. Positioning system 310 may be, e.g., a hydraulic device, thatrestricts movement of slave unit 502 with respect to slave unit 501along a single plane. For example, the position of pulley P8 may befixed, such that the position of P15 is moveable relative to P8 alongthe horizontal plane (x- and y-direction).

Referring now to FIGS. 34A and 34B, components of an exemplary masterunit of system 100 is described. As master unit 401 is identical instructure to master unit 402, respectively, the description below ofmaster unit 401 applies also to master unit 402.

Master unit 401 includes a plurality of master links, e.g., first masterlink 405 a, second master link 405 b, third master link 405 c, andfourth master link, e.g., guided master link 404, interconnected by aplurality of master joints. Handle 403 is connected to a distal end ofmaster unit 401 via guided master link 404, e.g., master rod, andincludes a plurality of handle links interconnected by a plurality ofhandle joints for operating the hybrid telemanipulator. For example,translational macro-movement applied on handle 403 causes correspondingmovement of the plurality of master joints via the plurality of masterlinks, which is transmitted to the corresponding slave joints of slaveunit 501 via mechanical transmission 300, thereby replicating thetranslational macro-movement at slave unit 501. Translational movementof handle 403 causes guided master link 404 to transmit motion to pulleyP1 via first master link 405 a, second master link 405 b, and thirdmaster link 405 c, thereby causing slave unit 501 to mimic thetranslational movement via mechanical transmission 300. First masterlink 405 a, second master link 405 b, third master link 405 c, andguided master link 404 are coupled to pulley P1 via a transmissionsystem including, e.g., one or more toothed belts 406 routed via one ormore pulleys 407. Alternatively, the transmission system coupling pulleyP1 and the plurality of master links and joints of master unit 501 mayinclude a system of cables and pulleys, and/or rigid transmission links.

In FIGS. 34A and 34B, mechanical constraint 408 on master unit 401includes a yoke pivotally coupled to a sleeve that slides on guidedmaster link 404 and constrains movements of the distal end of slave unit501 in correspondence with a remote center of motion that is alignedwith the incision point on a patient, e.g., the point at which a trocarpasses into a patient's abdomen. For example, mechanical constraint 408ensures that, when the hybrid telemanipulator is actuated, guided masterlink 404 of master unit 401 translates along longitudinal axis θ₁ sothat the corresponding slave link of slave unit 501, e.g., translationalinstrument interface coupled to the distal end of slave unit 501, alsotranslates along virtual axis θ₄ parallel to longitudinal axis θ₁ ofguided master link 404 in the vicinity of the remote manipulation, asdepicted in FIGS. 35A and 35B. In addition, mechanical constraint 408enables guided master link 404 to rotate about second and third axes θ₂,θ₃ that are perpendicular to each other. Referring still to FIGS. 34Aand 34B, axis θ₃ is coaxial to the axis of pulley P1. The plane definedby longitudinal axis θ₁ of guided master link 404 and second axis θ₂intersects third axis θ₃ at stationary single point 409 independently ofthe orientation of master link 404. This configuration allows thecorresponding slave link of slave unit 501 to rotate about fifth andsixth virtual axes θ₅, θ₆ that are perpendicular to each other.Longitudinal axis θ₄ of the corresponding slave link and fifth and sixthvirtual axes θ₅, θ₆ always intersect each other at virtual stationarysingle point 509, e.g., the remote center-of-motion, in the vicinity ofthe patient incision.

When surgical robot system 100 is positioned such that remotecenter-of-motion 509 is aligned with the patient incision, translationalmovement applied to handle 403 is replicated by the end-effectordisposed inside the patient. Because the end-effector perfectlyreplicates the movement applied to handle 403, this arrangementadvantageously eliminates the fulcrum effect between the handle andend-effector, and ensures that the instrument always passes through theremote center-of-motion. Whereas in previously-known surgical robots,maintaining a fixed point of movement of the surgical instrument as itpasses through the patient incision requires complex controlelectronics, in the system of the present invention, mechanicalconstraint 408 provides translational replication between master unit401 and slave unit 501 that ensures that the instrument always passesthrough remote center-of-motion 509.

Inward/outward movement of handle 403 of the embodiments of FIGS. 34Aand 34B causes first master link 405 a, second master link 405 b, thirdmaster link 405 c, and guided master link 404 to move inward/outwardalong longitudinal axis θ₁ of guided master link 404. That motion istransmitted to pulley P1 via the plurality of master links, causingslave unit 501 to replicate the inward/outward movement aboutlongitudinal axis θ₄ via mechanical transmission 300 and the pluralityof slave links, joints, and timing belts. Similarly, movement of handle403 upward/downward causes first master link 405 a, second master link405 b, third master link 405 c, and guided master link 404 to rotateupward/downward about second axis θ₂. That motion is transmitted topulley P1 via the plurality of master links, in turn causing slave unit501 to replicate the upward/downward movement about fifth axis θ₅ viamechanical transmission 300 and the plurality of slave links, joints,and timing belts. Finally, movement of handle 403 left/right causesfirst master link 405 a, second master link 405 b, third master link 405c, and guided master link 404 to rotate left/right about third axis θ₃.That motion is transmitted to pulley P1 via the plurality of masterlinks, causing slave unit 501 to replicate the left/right movement aboutsixth axis θ₆ via mechanical transmission 300 and the plurality of slavelinks, joints, and timing belts.

Still referring to FIGS. 34A and 34B, movement applied at handle 403 ofmaster unit 401 actuates the articulation degrees-of-freedom, e.g.,pitch and yaw, the actuation degree-of-freedom, e.g., open/close, andthe rotation degree-of-freedom, e.g., pronosupination,electromechanically via sensors, motors, and a control system. Masterunit 401 preferably includes one or more sensors 410 coupled to handle403 via circuit board 411 for detecting motion of handle 403. As will beunderstood, sensor 410 may be any sensor designed to detect rotationalmovement, such as magnetic-based rotational sensors that includes amagnet on one side and a sensor on another side to measure rotation bymeasuring angle and position. Circuit board 411 is coupled to a controlsystem for generating signals indicative of the rotation measured bysensor 410 and transmitting the signals to one or more motors coupled toslave unit 501, which may reproduce movements applied on handle 403 tothe end effector. For example, electrical cables may extend from handle403 to the control system, e.g., a unit containing control electronics,and additional electrical cables may extend from the control system tothe one or more motors coupled to slave unit 501.

Actuation of trigger 412 of handle 403 generates a signal that istransmitted via the control system to the motors coupled to slave unit501, thereby causing actuation of a translation transmission system ofthe translational instrument interface coupled to slave unit 501, inturn causing actuation of the end-effector of the translationalinstrument interface to open/close.

Handle 403 also may include ball 413 designed to be easily gripped bythe surgeon and which aligns the surgeon's wrist with master unit 401.Ball 413 may be rotatable about handle axis θ₇, such that the rotationof ball 413 is detected by a sensor that generates and transmits asignal via the control system to a motor coupled to slave unit 501. Thesignal received from the control system at the slave unit causesrotation of the translational instrument interface coupled to slave unit501, thus rotating the end-effector of the translational instrumentinterface in the pronosupination degree-of-freedom.

Handle 403 also is rotatable about handle axis θ₈, such that therotation about handle axis θ₈ is detected by a sensor, which generatesand transmits a signal via the control system to the motors of slaveunit 501. That signal causes actuation of the translation transmissionsystem of the translational instrument interface coupled to slave unit501, which in turn causes movement of the end-effector of thetranslational instrument interface in the yaw degree-of-freedom. Inaddition, handle 403 may be rotatable about handle axis θ₉, such thatthe rotation of handle 403 about handle axis θ₉ is detected by a sensor,which generates and transmits a signal via the control system to themotors of slave unit 501. That signal causes actuation of thetranslation transmission system of the translational instrumentinterface coupled to slave unit 501, which causes movement of theend-effector of the translational instrument interface in the pitchdegree-of-freedom.

Referring now to FIGS. 34C and 34D, alternative embodiments of thehandle of master unit 401 are described. In FIG. 34C, handle 403′ isrotatable about handle axis θ₇, handle axis θ₈, and handle axis θ₉, suchthat rotation of handle 403′ about the handle axes is detected by one ormore sensors 410, which generate and transmit a signal via the controlsystem to motors of slave unit 501. That signal actuates the translationtransmission system of the translational instrument interface coupled toslave unit 501, causing movement of the end-effector of thetranslational instrument interface in the pronosupination, yaw, andpitch degrees-of-freedom, respectively.

Similarly, handle 403″ of FIG. 34D is rotatable about handle axis θ₇,handle axis θ₈, and handle axis θ₉, such that rotation of handle 403″about the handle axes is detected by one or more sensors 410, whichgenerates and transmits a signal via the control system to the one ormore motors coupled to slave unit 501. That signal actuates thetranslation transmission system of the translational instrumentinterface coupled to slave unit 501, causing movement of theend-effector of the translational instrument interface in thepronosupination, yaw, and pitch degrees-of-freedom, respectively.

Referring now to FIGS. 35A and 35B, an exemplary slave unit of system100 is described. As slave unit 501 is identical in structure to slaveunit 502, respectively, the description below of slave unit 501 appliesalso to slave unit 502.

As described above, master unit 401 includes a plurality of master linksinterconnected by a plurality of master joints. Slave unit 501 includesa corresponding plurality of slave links, e.g., first slave link 505 a,second slave link 505 b, third slave link 505 c, and fourth slave link,e.g., translational instrument interface 503, interconnected by aplurality of slave joints, such that a direct mechanical coupling isformed by the plurality of slave links and corresponding plurality ofslave joints of slave unit 501, which is identical to the kinematicmodel formed by the corresponding plurality of master links andcorresponding plurality of master joints of master unit 401. Forexample, first slave link 505 a always remains parallel to first masterlink 405 a, second slave link 505 b always remains parallel to secondmaster link 405 b, third slave link 505 c always remains parallel tothird master link 405 c, and translational instrument interface 503always remains parallel to guided master link 404 during operation ofthe hybrid telemanipulator. Thus, each translational macro-movementapplied to the plurality of master joints of master unit 401 isreplicated by a corresponding respective joint of the plurality of slavejoints of slave unit 501 via mechanical transmission 300 and theplurality of slave links.

In FIGS. 35A and 35B, translational instrument interface 503 is coupledto distal end 504 of slave unit 501. Translational movement of handle403 is transmitted to pulley P9 via mechanical transmission 300. Morespecifically, translational actuation of handle 403 causes pulley P9 totransmit motion to end-effector 512 via first slave link 505 a, secondslave link 505 b, third slave link 505 c, and translational instrumentinterface 503, thereby causing slave unit 501 to replicate thetranslational movement. First slave link 505 a, second slave link 505 b,third slave link 505 c, and translational instrument interface 503 arecoupled to pulley P9 via a transmission system including, e.g., one ormore timing belts 506 routed via one or more pulleys 507. Thus, each ofthe four pulleys of P9 is operatively coupled to and controls movementof first slave link 505 a, second slave link 505 b, third slave link 505c, and translational instrument interface 503. Alternatively, thetransmission system coupling pulley P9 and the plurality of slave linksand joints of slave unit 501 may include a system of cables and pulleys,and/or rigid transmission links.

Mechanical constraint 408 of master unit 401 ensures that, when thehybrid telemanipulator is in operation, first slave link 505 a, secondslave link 505 b, third slave link 505 c, and translational instrumentinterface 503 always rotate about virtual stationary point 509. Forexample, end-effector 512 of translational instrument interface 503coupled to slave unit 501 always translates along longitudinal axis θ₄corresponding to the longitudinal axis θ₁ of master link 404 in thevicinity of the remote manipulation. In addition, mechanical constraint408 allows end-effector 512 to rotate about fifth and a sixth virtualaxis θ₅, θ₆ that are perpendicular to each other. Longitudinal axis θ₄of translational instrument interface 503 coupled to slave unit 501, andfifth and sixth virtual axes θ₅, θ₆ always intersect each other atvirtual stationary single point 509 in the vicinity of the remotemanipulation. During a minimally invasive surgical procedure, virtualstationary point 509 is aligned with the surgical incision point,reducing trauma to the patient and improving cosmetic outcomes of thesurgery.

Movement of handle 403 in the inward/outward directions causes endeffector 512 coupled to slave unit 501 to replicate the inward/outwardmovement about longitudinal axis θ₄ via mechanical transmission 300 andthe transmission system coupling pulley P9 and the plurality of slavelinks and joints of slave unit 501. Movement of handle 403upward/downward causes end effector 512 coupled to slave unit 501 toreplicate the upward/downward movement about longitudinal axis θ₅ viamechanical transmission 300 and the transmission system coupling pulleyP9 and the plurality of slave links and joints of slave unit 501.Movement of handle 403 left/right causes end effector 512 coupled toslave unit 501 to replicate the left/right movement about longitudinalaxis θ₆ via mechanical transmission 300 and the transmission systemcoupling pulley P9 and the plurality of slave links and joints of slaveunit 501.

In addition, movement applied at handle 403 of master unit 401 actuatesthe articulation degrees-of-freedom, e.g., pitch and yaw, the actuationdegree-of-freedom, e.g., open/close, and the rotation degree-of-freedom,e.g., pronosupination of the end-effector of translational instrumentinterface 503, electromechanically via sensors, motors, and a controlsystem. Translational instrument interface 503 may be constructed asdescribed in U.S. Patent Publication No. 2018/0353252 to Chassot,assigned to the assignee of the instant application, the entire contentsof which are incorporated by reference herein. For example,translational instrument interface 503 includes slave hub 510 andsurgical instrument 511. Slave hub 510 may be affixed to distal end 504of slave unit 501. Surgical instrument 511 includes end-effector 512disposed at the distal end of the shaft of surgical instrument 511, andmay be removeably coupled to slave hub 510. A sterile interface may bepositioned between slave hub 510 and surgical instrument 511. Inaddition, translational instrument interface 503 includes a translationtransmission system that extends from one or more motors positionedwithin slave hub 510 to the components of end-effector 512. For example,end-effector 512 includes a plurality of end-effector linksinterconnected by a plurality of end-effector joints coupled to thetranslation transmission system of translational instrument interface503, such that actuation of the translation transmission system by theone or more motors causes movement of end-effector 512 via the pluralityof end-effector links and joints.

Further details regarding the components and operation of slave hub 510are described with respect to FIGS. 36A and 36B. Slave hub 510 oftranslational instrument interface 503 affixed to slave unit 501includes one or more motors, e.g., first motor 601 a, second motor 601b, third motor 601 c, and fourth motor 601 d, operatively coupled, e.g.,via electrical wiring, with the control system via circuit board 602.Motors 601 a-601 d receive signals indicative of measured movements andtrigger actuation of handle 403, as measured by one or more sensors 410coupled to handle 403. Those signals are processed by the controlsystem, which in turn provides signals to the motors that actuatetranslational instrument interface 503 to thereby replicate themicro-movements corresponding to those input at handle 403. First motor601 a, second motor 601 b, and third motor 601 c are coupled directly totranslation transmission system 603 of translational instrumentinterface 503 for actuating end-effector 512 in the open/close, pitch,and yaw degrees-of-freedom. Translation transmission system 603 includesa plurality of transmission elements, e.g., cables and/or lead screws,such that each of the plurality of transmission elements are coupled tofirst motor 601 a, second motor 601 b, and third motor 601 c at one end,and to the first, second, and third end-effector links at the oppositeend, to move the end-effector in the open/close, pitch, and yawdegrees-of-freedom. Translation transmission system 603 may include aplurality of lead screws and/or closed cable loops. Fourth motor 601 dactuates rotation of slave instrument 503 via pronosupination timingbelt 513. As will be understood by a person having ordinary skill in theart, slave hub 510 may include any combination of motors 601 a-601 d,e.g., only the one or more motors for actuating end-effector 512 in theopen/close degree-of-freedom and the motor for rotating end-effector 512in the pronosupination degree-of-freedom when a non-articulatedinstrument is used.

Circuit board 602 also may include one or more sensors designed todetect undesired movement of translational instrument interface 503, andelectrically communicate with first motor 601 a, second motor 601 b,third motor 601 c, and fourth motor 601 d to resist such undesiredmovement.

In accordance with one aspect of the present invention, the controlsystem may identify the kinematics of end-effector 512 of translationalinstrument interface 503 by reading out identifier element 516, e.g.,RFID token integrated with the instrument, as shown in FIG. 36C, whereinthe RFID token contains information on the kinematic configuration ofthe instrument. In particular, the control system, based on theinformation read from identifier element 516, may configure operation ofthe one or more motors that interface with translational instrumentinterface 503 to operate differently (e.g. to turn simultaneouslyclockwise or one clockwise and the other counterclockwise) to causeactuations of the end-effector elements. For example, in FIG. 36D, aforceps-type end-effector having parallel-serial instrument kinematicsis described. For this configuration, first motor 601 a may beoperatively coupled to a first link of end-effector 512′, e.g., a firstblade, via transmission element 514 a of the translation transmissionsystem, such that first motor 601 a causes the first link ofend-effector 512′ to move outward/inward. Second motor 601 b may beoperatively coupled to a second link of end-effector 512′, e.g., secondblade, via transmission element 514 b of the translation transmissionsystem, such that second motor 601 b causes the second link ofend-effector 512′ to move outward/inward. Thus, the control system mayinstruct first motor 601 a to move the first link of end-effector 512′outward via transmission element 514 a, while simultaneously instructingsecond motor 601 b to move the second link of end-effector 512′ outwardvia transmission element 514 b, thereby causing end-effector 512′ toopen based on actuation of trigger 412 of handle 403. Conversely, thecontrol system may instruct first motor 601 a to move the first link ofend-effector 512′ inward via transmission element 514 a, whilesimultaneously instructing second motor 601 b to move the second link ofend-effector 512′ inward via transmission element 514 b, thereby causingend-effector 512′ to close based on actuation of trigger 412 of handle403. Therefore, first motor 601 a and second motor 601 b may causeend-effector 512′ to move in the open/close degree-of-freedom.

The control system may instruct first motor 601 a to move the first linkof end-effector 512′ outward via transmission element 514 a, whilesimultaneously instructing second motor 601 b to move the second link ofend-effector 512′ inward via transmission element 514 b, thereby causingend-effector 512′ to pitch upward based on rotation of handle 403 abouthandle axis θ₉. Conversely, the control system may instruct first motor601 a to move the first link of end-effector 512′ inward viatransmission element 514 a, while simultaneously instructing secondmotor 601 b to move the second link of end-effector 512′ outward viatransmission element 514 b, thereby causing end-effector 512′ to pitchdownward based on rotation of handle 403 about handle axis θ₉.Therefore, first motor 601 a and second motor 601 b may causeend-effector 512′ to move in the pitch degree-of-freedom.

Third motor 601 c may be operatively coupled to a third link ofend-effector 512′ via transmission element 514 c of the translationtransmission system such that third motor 601 c causes end-effector 512′to move in the yaw degree-of-freedom based on rotation of handle 403about handle axis Os. Fourth motor 601 d may be operatively coupled tofirst motor 601 a, second motor 601 b, third motor 601 c, and surgicalinstrument 511 via a rotatable pronosupination timing belt 513 such thatfourth motor 601 d causes first motor 601 a, second motor 601 b, thirdmotor 601 c, and surgical instrument 511, and thereby end-effector 512′,to rotate in the pronosupination degree-of-freedom based on rotation ofball 413 of handle 403.

Referring now to FIG. 36E, an end-effector having serial-serialinstrument kinematics is described. For example, first motor 601 a maybe operatively coupled to a first link of end-effector 512″ viatransmission element 515 a of the translation transmission system suchthat first motor 601 a causes end-effector 512″ to move in theopen/close degree-of-freedom based on actuation of trigger 412 of handle403. Second motor 601 b may be operatively coupled to a second link ofend-effector 512″ via transmission element 515 b of the translationtransmission system such that second motor 601 b causes end-effector512″ to move in the pitch degree-of-freedom based on rotation of handle403 about handle axis θ₉. Third motor 601 c may be operatively coupledto a third link end-effector 512″ via transmission element 515 c of thetranslation transmission system such that third motor 601 c causesend-effector 512″ to move in the yaw degree-of-freedom based on rotationof handle 403 about handle axis Os. Fourth motor 601 d may beoperatively coupled to first motor 601 a, second motor 601 b, thirdmotor 601 c, and surgical instrument 511 via a rotatable pronosupinationtiming belt 513 such that fourth motor 601 d causes first motor 601 a,second motor 601 b, third motor 601 c, and surgical instrument 511, andthereby end-effector 512″, to rotate in the pronosupinationdegree-of-freedom based on rotation of ball 413 of handle 403.

In accordance with one aspect of the invention, the control system mayread information stored on identifier element 516, e.g., an RFID token,that is integrated with the instrument to identify the kinematics ofend-effector 512 of translational instrument interface 503, as outlinedin method steps 700 enumerated in FIG. 37. At step 701, the user selectsa surgical instrument having an end-effector to be used with the hybridtelemanipulator. For example, the surgical instrument may have anend-effector having parallel-serial instrument kinematics as shown inFIG. 36D or serial-serial instrument kinematics as shown in FIG. 36E.The surgical instrument then may be coupled to the slave unit of thehybrid telemanipulator. At step 702, the control system detectsinformation for the kinematic configuration of the selectedend-effector. For example, the control system may read out an RFID tokenintegrated with surgical instrument 511, which contains information onthe kinematic configuration of the selected end-effector, e.g., whetherthe selected end-effector has parallel-serial instrument kinematics orserial-serial instrument kinematics. The RFID token may be, for example,an inductively-read microchip that contains identification informationthat may be scanned by a reader disposed on the slave hub andoperatively coupled to the control system. Alternatively, the functionof identifier element 516 may be provided by, e.g., an optical tag suchas a bar code, QR code, Datamatrix, Aztec code, or Semacode, disposed onthe surgical instrument 511 that is read by the slave hub. If thesurgical instrument has not yet been coupled to the slave unit of thehybrid telemanipulator, surgical instrument may be coupled to the slaveunit of the hybrid telemanipulator after step 702.

At step 703, the control system identifies the kinematics of theselected end-effector based on the information detected at step 702 todetermine which type of end-effector is coupled to the slave unit of thehybrid telemanipulator. At step 704, the control system adjusts itsparameters based on the identity of the selected end-effector so thatthe hybrid telemanipulator may be properly actuated. For example, if theend-effector has parallel-serial instrument kinematics, the controlsystem will include parameters that instruct first motor 601 a andsecond motor 601 b to simultaneously actuate the first and secondend-effector links to move the end-effector in the open/close and pitchdegrees-of-freedom as described above. If the end-effector hasserial-serial instrument kinematics, the control system will includeparameters that instruct first motor 601 a to actuate the end-effectorin the open/close degree-of-freedom, and second motor 601 b to actuatethe end-effector in the pitch degree-of-freedom as described above.

Referring to FIG. 38, an alternative exemplary embodiment of a remotelyactuated surgical robot system wherein all degrees-of-freedom arecontrolled electromechanically is described. Although all seven of thedegrees-of-freedom, e.g., inward/outward, upward/downward, left/right,yaw, pitch, open/close, and pronosupination, are controlledelectromechanically via a system of sensors, motors, and a controlsystem, system 800 retains a mechanical constraint element as describedabove at the master unit, thereby creating a single virtual stationarypoint, e.g., remote center-of-motion, at the slave unit. Therefore,system 800 does not require coordinate transform and complex controlsystem to align slave unit 1001 with an incision. The mechanicalconstraint and the corresponding remote-center-of-motion ensure thatthis design, is much simpler and safer than when using generic roboticarms.

Referring now to FIG. 39, master unit 901 is constructed similarly tomaster unit 401 of FIGS. 34A and 34B, except that instead of a pluralityof cables and pulleys of the mechanical transmission coupled to pulleyP1, master unit 901 includes one or more sensors, e.g., sensor 902 a,sensor 902 b, sensor 902 c, and sensor 902 d, operatively coupled toeach of the four pulleys of pulley P1. Sensors 902 a-902 d measurerotational movement by measuring angle and position of pulley P1 inresponse to movement applied to handle 903 of master unit 901 via aplurality of master links, joints, and cables. Each of the four sensorsmeasures movement of a joint of master unit 901 via each of the fourpulleys of pulley P1, thereby measuring movement of master unit 901 infour degrees-of-motion. However, the mechanical constraint constrainsmovement of master unit 901 by removing one degree-of-freedom of motion,thereby resulting in movement of slave unit 1001 in threedegrees-of-freedom of motion, e.g., inward/outward, upward/downward, andleft/right.

Handle 903 is constructed similarly to handle 403 of FIGS. 34A and 34B.For example, handle 903 includes one or more sensors 410 and circuitboard 411, such that micro movements applied at handle 903 may betransmitted to the end-effector of slave unit 1001 via one or moresensors 410 and the one or more motors coupled to the end-effector ofslave unit 1001 to move the end-effector in the open/close, pitch, yaw,and pronosupination degrees-of-freedom.

Regarding transmission of macro-movements, sensor 902 a, sensor 902 b,sensor 902 c, and sensor 902 d generate signals indicative of themeasured rotation of pulley P1 by the respective sensors, and transmitthe signals to one or more motors coupled to slave unit 1001 via acontrol system, to thereby replicate the translational macro-movementsapplied at handle 903 coupled to master unit 901. For example,electrical cables may extend from master unit 901 to the control system,e.g., unit containing control electronics, and additional electricalcables may extend from the control system to the one or more motorscoupled to slave unit 1001.

With respect to FIGS. 40A and 40B, slave unit 1001 is constructedsimilarly to slave unit 501 of FIGS. 35A and 35B. For example, slaveunit 1001 includes first motor 601 a, second motor 601 b, third motor601 c, and fourth motor 601 d operatively coupled to the end-effector ofslave unit 1001, such that micro-movements applied at handle 903 may betransmitted to the end-effector of slave unit 1001 via one or moresensors 410, and first motor 601 a, second motor 601 b, third motor 601c, and fourth motor 601 d to move the end-effector in the open/close,pitch, yaw, and pronosupination degrees-of-freedom. Slave unit 1001differs from slave unit 501 in that instead of a plurality of cables andpulleys of the mechanical transmission coupled to pulley P8, slave unit1001 includes one or more motors, e.g., first motor 1002 a, second motor1002 b, third motor 1002 c, and fourth motor 1002 d, operatively coupledto each of the four pulleys of pulley P8. The one or more motors arecoupled to a circuit board for receiving signals indicative of themeasured rotation of pulley P1 by sensor 902 a, sensor 902 b, sensor 902c, and sensor 902 d in response to movement applied to handle 903 ofmaster unit 901, to thereby actuate pulley P8 to replicate thetranslational macro-movements applied on handle 903 coupled to masterunit 901 at slave unit 1001 via a plurality of slave links, joints,timing belts, and/or a system of cables and pulleys. For example, firstmotor 1002 a is operatively coupled to and controls movement of firstslave link 505 a, second motor 1002 b is operatively coupled andcontrols movement of to second slave link 505 b, third motor 1002 c isoperatively coupled to and controls movement of third slave link 505 c,and fourth motor 1002 d is operatively coupled to and controls movementof translational instrument interface 503 via pulley P8 and theplurality of slave joints, timing belts, and/or system of cables andpulleys.

As the mechanical constraint of master unit 901 constrains movement ofmaster unit 901 to movement in three degrees-of-freedom, e.g.,inward/outward, upward/downward, and left/right, movement of first slavelink 505 a, second slave link 505 b, third slave link 505 c, andtranslational instrument interface 503 of slave unit 1001 by first motor1002 a, second motor 1002 b, third motor 1002 c, and fourth motor 1002d, respectively, is constrained to movement in three degrees-of-freedom,e.g., inward/outward, upward/downward, and left/right, about virtualstationary point 1005, e.g., remote center-of-motion.

Slave unit 1001 may include temporary incision pointer 1004 which pointsto virtual stationary point 1005, e.g., remote center-of-motion, createdby the mechanical restraint at master unit 1001, such that virtualstationary point 1005 may be brought in coincidence with the surgicalincision point, reducing trauma to the patient and improving cosmeticoutcomes of the surgery. Temporary incision pointer 1004 may be removedprior to operation of surgical robot system 800.

Referring now to FIGS. 41A and 41B, alternative embodiments of thecontrol system of the surgical robot system are described. Controlsystem 1100 of FIG.41A, which may be integrated with system 100,includes non-transitory computer readable media, e.g., memory 1101,having instructions stored thereon that, when executed by processor 1102of control system 1100 allow operation of the hybrid telemanipulators.In addition, control system 1100 may communicate with identifier elementreader 517 of slave unit 501, either wirelessly or using an electriccable, so that memory 1101 may store the identity of the kinematicconfiguration of the end-effector read from identifier element 516, suchthat the instructions, when executed by processor 1102, cause the motorsfor controlling the end-effector in the open/close and pitchdegrees-of-freedom to behave in accordance to the type of end-effectorselected. Control system 1100 is electrically coupled, either wirelesslyor using an electric cable, to the circuit boards of master unit 401and, thereby, to one or more sensors 410 for receiving signalsindicative of micro movements applied at handle 403. In addition,control system 1100 is electrically coupled, either wirelessly or usingan electric cable, to the circuit boards of slave unit 501 and, thereby,to first motor 601 a, second motor 601 b, third motor 601 c, and fourthmotor 601 d for actuating the micro movements of the end-effector, e.g.,in the open/close, pitch, yaw, and pronosupination degrees-of-freedom.

Control system 1110 of FIG. 41B, which may be integrated with system800, includes non-transitory computer readable media, e.g., memory 1111,having instructions stored thereon that, when executed by processor 1112of control system 1110 allow operation of the hybrid telemanipulators.In addition, control system 1110 may communicate with identifier elementreader 517 of slave unit 1001, either wirelessly or using an electriccable, and memory 1111 may store the identity of the kinematicconfiguration of the end-effector read from identifier element 516, suchthat the instructions, when executed by processor 1112, cause the motorsfor controlling the end-effector in the open/close and pitchdegrees-of-freedom to behave in accordance to the type of end-effectorselected. Control system 1110 is electrically coupled, either wirelesslyor using an electric cable, to the circuit boards of master unit 901and, thereby, to one or more sensors 410 for receiving signalsindicative of micro movements applied at handle 903, and to sensor 902a, sensor 902 b, sensor 902 c, and sensor 902 d for receiving signalsindicative of macro movements applied at handle 903. In addition,control system 1110 is electrically coupled, either wirelessly or usingan electric cable, to the circuit boards of slave unit 1001 and,thereby, to first motor 601 a, second motor 601 b, third motor 601 c,and fourth motor 601 d for actuating the micro movements of theend-effector, e.g., in the open/close, pitch, yaw, and pronosupinationdegrees-of-freedom, and to first motor 1002 a, second motor 1002 b,third motor 1002 c, and fourth motor 1002 d for actuating themacro-movements of the end-effector, e.g., in the inward/outward,upward/downward, and left/right degrees-of-freedom.

Referring now to FIGS. 42A and 42B, alternative applications of theprinciples of the present invention may be applied to alternativetelemanipulator designs. For example, a telemanipulator constructed asdescribed in U.S. Pat. No. 9,696,700 to Beira, depicted in FIG. 42A, maybe modified to include handles and translational instrument interfacesfor electromechanically controlling the micro movements of theend-effector, e.g., open/close, pitch, yaw, and pronosupinationdegrees-of-freedom, while the translational macro movements of the endeffector, e.g., upward/downward, inward/outward, and left/rightdegrees-of-freedom, are controlled mechanically by a mechanicaltransmission system. Remotely actuated surgical robot system 1200includes master unit 1201 directly mechanically coupled to slave unit1202, handle 1203 coupled to master unit 1201, translational instrumentinterface 1204 coupled to slave unit 1202, and mechanical constraint1205. Handle 1203 may be constructed similarly to handle 403 of FIGS.34A and 34B, and translational instrument interface 1204 likewise may beconstructed similarly to translational instrument interface 503 of FIGS.35A and 35B. For example, handle 1203 includes one or more sensors, suchthat micro-movements applied at handle 1203 may be transmitted to theend-effector of translational instrument interface 1204 via the one ormore sensors and one or more motors coupled to the end-effector of slaveunit 1202 to move the end-effector in the open/close, pitch, yaw, andpronosupination degrees-of-freedom. Accordingly, the translationalmacro-movements applied at handle 1201 will be replicated bytranslational instrument interface 1204 in three degrees-of-freedom,e.g., inward/outward, upward/downward, and left/right, due to mechanicalconstraint 1203. Alternatively, remotely actuated surgical robot system1200 may have seven degrees-of-freedom actuated electromechanically.

With respect to FIG. 42B, an alternative telemanipulator is described.For example, a telemanipulator constructed as described in U.S. PatentPub. No. 2017/0245954 to Beira, may be modified to include handles andtranslational instrument interfaces for electromechanically controllingthe micro-movements of the end-effector, e.g., open/close, pitch, yaw,and pronosupination degrees-of-freedom, while the translationalmacro-movements of the end effector, e.g., upward/downward,inward/outward, and left/right degrees-of-freedom, are controlledmechanically by a mechanical transmission system. Remotely actuatedsurgical robot system 1210 includes master unit 1211 mechanicallycoupled to slave unit 1212, handle 1213 coupled to master unit 1211,translational instrument interface 1214 coupled to slave unit 1212, andmechanical constraint 1215. Handle 1213 is constructed similarly tohandle 403 of FIGS. 34A and 34B, and translational instrument interface1214 is constructed similarly to translational instrument interface 503of FIGS. 35A and 35B. For example, handle 1213 includes one or moresensors, such that micro-movements applied at handle 1213 may betransmitted to the end-effector of translational instrument interface1214 via the one or more sensors and one or more motors coupled to theend-effector of slave unit 1212 to move the end-effector in theopen/close, pitch, yaw, and pronosupination degrees-of-freedom.Accordingly, the translational macro-movements applied at handle 1213will be replicated by the end-effector of translational instrumentinterface 1214 in three degrees-of-freedom, e.g., inward/outward,upward/downward, and left/right, due to mechanical constraint 1213.Alternatively, remotely actuated surgical robot system 1210 may haveseven degrees-of-freedom actuated electromechanically.

While various illustrative embodiments of the invention are describedabove, it will be apparent to one skilled in the art that variouschanges and modifications may be made therein without departing from theinvention. The appended claims are intended to cover all such changesand modifications that fall within the true scope of the invention.

What is claimed:
 1. A system for remote manipulation to perform surgery,the system comprising: a slave console comprising a plurality of slavelinks, the slave console operatively coupled to a master console andconfigured to move responsive to movement applied at a handle of themaster console; and a controller operatively coupled to a plurality ofactuators coupled to the plurality of slave links of the slave console,the controller configured to execute instructions to: disengage one ormore wheel locks of the slave console to permit the slave console to bepositioned adjacent a patient undergoing the surgery, and to reengagethe one or more wheel locks of the slave console when the slave consoleis in a desired position; cause the plurality of actuators to move adistal end of the slave console via the plurality of slave links to adesired position over the patient undergoing the surgery; and cause theplurality of actuators to adjust a vertical height of the slave consolevia the plurality of slave links relative to the patient undergoing thesurgery such that the distal end of the slave console is at a desiredheight relative to a trocar within the patient undergoing the surgery.2. The system of claim 1, wherein the controller is further configuredto execute instructions to flip the distal end of the slave consolebetween a forward surgical workspace and a reverse surgical workspace.3. The system of claim 1, wherein the controller is further configuredto execute instructions to move the plurality of slave links away fromthe patient such that a surgeon may manually perform surgery on thepatient.
 4. The system of claim 1, wherein the controller is furtherconfigured to execute instructions to determine whether a sterileinterface coupled to the distal end of the slave console is identified.5. The system of claim 1, wherein the controller is further configuredto execute instructions to determine whether an instrument coupled tothe distal end of the slave console is authorized.
 6. The system ofclaim 1, wherein the controller is further configured to executeinstructions to move the plurality of slave links such that the slaveconsole may be transported and stored.
 7. The system of claim 1, furthercomprising an end-effector coupled to the distal end of the slaveconsole, the end-effector configured to move responsive to actuation atthe handle and to move responsive to movement at the slave console toperform the surgery.
 8. The system of claim 7, wherein the controller isfurther configured to execute instructions to adjust an angle of a slavelink of the plurality of slave links to permit the end-effector toperform the surgery in a semi-spherical workspace, the semi-sphericalworkspace tilted at the adjusted angle.
 9. The system of claim 7,wherein the controller is further configured to execute instructions tomove the plurality of slave links to a retracted home configuration suchthat the end-effector is positionable within the trocar within thepatient undergoing the surgery.
 10. The system of claim 1, furthercomprising a removable incision pointer configured to permit alignmentof the distal end of the slave console with the trocar positioned withinthe patient undergoing the surgery.
 11. A method for remote manipulationof a slave console in a robotic system for performing surgery, themethod comprising: disengaging one or more wheel locks of the slaveconsole to permit the slave console to be positioned adjacent a patientundergoing the surgery; reengaging the one or more wheel locks of theslave console when the slave console is in a desired position; releasinga Scara brake to permit a distal end of the slave console to be moved toa desired position over the patient undergoing the surgery; andadjusting a vertical height of the slave console relative to the patientundergoing the surgery such that the distal end of the slave console isat a desired height relative to a trocar within the patient undergoingthe surgery.
 12. The method of claim 11, wherein the one or more wheellocks of the slave console may only be disengaged when no instrument iscoupled to the distal end of the slave console.
 13. The method of claim11, wherein the distal end of the slave console may only be moved to thedesired position over the patient undergoing the surgery when noinstrument is coupled to the distal end of the slave console.
 14. Themethod of claim 11, further comprising adjusting an angle of a slavelink of the slave console to permit an end-effector coupled to thedistal end of the slave console to perform the surgery in asemi-spherical workspace, the semi-spherical workspace tilted at theadjusted angle.
 15. The method of claim 11, further comprising flippingthe distal end of the slave console between a forward surgical workspaceand a reverse surgical workspace.
 16. The method of claim 11, furthercomprising moving slave links of the slave console to a retracted homeconfiguration such that an end-effector coupled to the distal end of theslave console is positionable within the trocar within the patientundergoing the surgery.
 17. The method of claim 11, further comprisingmoving slave links of the slave console away from the patient such thata surgeon may manually perform surgery on the patient.
 18. The method ofclaim 11, further comprising receiving a sterile interface input anddetermining whether a sterile interface coupled to the distal end of theslave console is identified based on the sterile interface input. 19.The method of claim 11, further comprising receiving an instrument inputand determining whether an instrument coupled to the distal end of theslave console is authorized based on the instrument input.
 20. Themethod of claim 11, further comprising moving slave links of the slaveconsole to a configuration such that the slave console may betransported and stored.